康庐琛 余杰

【摘要】 目的：探讨沙格列汀联合二甲双胍对2型糖尿病（T2DM）患者血糖水平及胰岛β细胞功能的影响。方法：选取2017年11月-2019年10月于本院治疗的T2DM患者84例，按随机数字表法将其分为对照组与观察组，各42例。对照组进行二甲双胍治疗，观察组在对照组基础上加用沙格列汀治疗。比较两组治疗前后血糖水平[糖化血红蛋白（HbA1c）、空腹血糖（FBG）、餐后2 h血糖（2 h PBG）]及胰岛β细胞功能[胰岛素抵抗指数（HOMA-IR）、胰岛β细胞功能指数（HOMA-β）]。结果：治疗后，观察组HbA1c、FBG、2 h PBG及HOMA-IR均低于对照组，且HOMA-β高于对照组（P<0.05）。两组不良反应发生率比较，差异无统计学意义（P>0.05）。结论：沙格列汀联合二甲双胍治疗T2DM安全有效，患者耐受性好，有利于降低血糖水平，改善胰岛β细胞功能，可作为T2DM患者联合用药的一种选择。

【关键词】 2型糖尿病 沙格列汀 二甲双胍 胰岛β细胞功能

Effects of Saxagliptin Combined with Metformin on Blood Glucose Levels and Islet β-cell Function in Type 2 Diabetes Mellitus/KANG Luchen， YU Jie. //Medical Innovation of China， 2021， 18（05）： 0-052

[Abstract] Objective： To investigate the effects of Saxagliptin combined with Metformin on blood glucose level and islet β-cell function in patients with type 2 diabetes mellitus （T2DM）. Method： A total of 84 T2DM patients treated in our hospital from November 2017 to October 2019 were selected. They were divided into control group and observation group according to the random number table method， with 42 cases in each group. The control group was treated with Metformin. The observation group was treated with Saxagliptin on the basis of the control group. Blood glucose levels [glycated hemoglobin （HbA1c）， fasting blood glucose （FBG）， 2 h postprandial blood glucose （2 h PBG）] and islet β-cell function [insulin resistance index （HOMA-IR）， islet β-cell function index （HOMA-β）] were compared between the two groups before and after treatment. Result： After treatment， HbA1c， FBG， 2 h PBG and HOMA-IR in the observation group were lower than those in the control group， and HOMA-β was higher than that in the control group （P<0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P>0.05）. Conclusion： The combination of Saxagliptin and Metformin is safe and effective in treating T2DM， the patients are well tolerated， which is conducive to lowering blood glucose levels and improving islet β-cell function， it can be used as a combination of T2DM patients.

[Key words] Type 2 diabetes Saxagliptin Metformin Islet β-cell function

First-authors address： The First Peoples Hospital of Jiujiang City， Jiujiang 332000， China

doi：10.3969/j.issn.1674-4985.2021.05.013

2型糖尿病（type 2 diabetes mellitus，T2DM）是一種多以胰岛β细胞功能异常及血糖水平异常升高为主要表现的代谢性疾病[1]。目前T2DM仍以药物治疗为主，二甲双胍作为首选用药，能够阻碍肠壁细胞对糖分的摄取，改善肝脏、肾脏糖异生作用，促使外周组织对葡萄糖利用度增强，达到降糖作用[2-3]。沙格列汀属于二肽基肽酶-4（dipeptidyl peptidse-4，DPP-4）抑制剂，能够对DPP-4进行抑制，改善胰高血糖素样肽1（glucagon-likepeptide 1，GLP-1）、葡萄糖依赖性促胰岛素释放多肽（glucose-dependent insulinotropic ploypeptide，GIP）水平，从而降低血糖[4-5]。鉴于此，本研究探讨了沙格列汀联合二甲双胍对T2DM血糖水平及胰岛β细胞功能的影响，现报道如下。

1 资料与方法

1.1 一般资料 选取2017年11月-2019年10月于本院治疗的T2DM患者84例，纳入标准：依据中华医学会制定的相关标准诊断为T2DM[6];可耐受沙格列汀、二甲双胍治疗;认知、理解功能正常，精神状态良好。……