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目的分析2型糖尿病患者应用西格列汀的短期疗效及其影响因素,为临床患者的选择及提高疗效提供依据。方法收集2012年9月至2014年6月住院并应用西格列汀的2型糖尿病患者86例病例资料。根据患者空腹C肽水平四分位数分为C肽水平最高组和C肽水平最低组,每组12例。采用多元线性逐步回归分析患者临床资料中影响血糖下降水平的因素。结果使用西格列汀后,C肽水平最高组与C肽水平最低组空腹血糖(FBG)下降值、餐后2 h血糖(2h-PBG)下降值及百分数差异无统计学意义(P>0.05)。糖化血红蛋白(Hb A1c)是影响FBG下降值及下降百分数的独立因素;用药前2h-PBG水平是影响2h-PBG下降值及其下降百分数的独立因素。患者使用西格列汀后,最大日内血糖波动值较使用前减小且低血糖发生显著减少(P<0.05)。结论西格列汀可同时降低患者FBG和2h-PBG,且疗效相当;其对FBG和2h-PBG的疗效不完全依赖于C肽水平;可显著减少血糖波动和低血糖事件的发生。
Objective To analyze the short-term effect of sitagliptin and its influencing factors in patients with type 2 diabetes mellitus (T2DM), and to provide evidences for the choice of clinical patients and their efficacy. Methods A total of 86 patients with type 2 diabetes admitted to our hospital from September 2012 to June 2014 were selected and receive sitagliptin. According to patients with fasting C-peptide levels quartiles divided into the highest C-peptide group and the lowest C-peptide group, 12 cases in each group. Multivariate linear stepwise regression analysis of clinical data in patients with factors that affect the level of blood glucose decline. Results After the administration of sitagliptin, there was no significant difference in FBG decrease, 2h-PBG decrease and percentages between the two groups with the highest C peptide level and the lowest C peptide level (P> 0.05 ). HbA1c was an independent factor that affected the decrease and the percentage decrease of FBG. The level of 2h-PBG before treatment was an independent factor affecting the decrease of 2h-PBG and its percentage decrease. After using sitagliptin, the maximal intra-day blood glucose fluctuation was decreased and hypoglycemia was significantly reduced (P <0.05). Conclusions Sedrin can reduce both FBG and 2h-PBG in patients with similar efficacy. The effects of sitagliptin on FBG and 2h-PBG are not completely dependent on C-peptide levels, and can significantly reduce the occurrence of blood glucose and hypoglycemia.