目的:分析吡格列酮二甲双胍片联合达格列净片治疗2型糖尿病(Diabetes mellitus type 2,T2DM)的疗效及对糖脂代谢、血清C反应蛋白(C-reactive Protein,CRP)、基质金属蛋白酶-9(Matrix metalloproteinas-9,MMP-9)水平的影响.方法:以治疗方案的不同将我院 2018 年 1 月至 2022 年 1 月接收的 102 例T2DM患者分为参照组(吡格列酮二甲双胍片治疗)和联合组(吡格列酮二甲双胍片+达格列净片治疗),两组各51例.观察治疗3 m后疗效、治疗期间不良反应.于治疗前及治疗后以高效液相法测定糖化血红蛋白(Glycosylated hemoglobin,HbAlc);以放射免疫分析法测定空腹胰岛素(Fasting insulin,FIns);用血糖仪检测餐后 2 h 血糖(2 h postprandial blood glucose,2hPG)、空腹血糖(Fasting blood-glucose,FPG);同时采用全自动生化分化仪以终点法检测甘油三酯(Triglyceride,TG)、高密度脂蛋白胆固醇(High density lipoprotein cholesterol,HDL-C)、总胆固醇(Total cholesterol,TC)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterol,LDL-C)水平.结果:联合组总有效率高于参照组(P＜0.05);与治疗前相比,治疗后两组2hPG、FPG、HbAlc、FIns水平均降低(P＜0.05),其中联合组更为显著(P＜0.05);与治疗前相比,治疗后两组TG、TC、LDL-C水平均降低,HDL-C升高(P＜0.05),其中联合组变化更为显著(P＜0.05);与治疗前相比,治疗后两组CRP、MMP-9、CysC、Hcy水平均降低(P＜0.05),其中联合组更为显著(P＜0.05);联合组不良反应总发生率与参照组相比无明显差异(P＞0.05).结论:吡格列酮二甲双胍片联合达格列净片治疗T2DM疗效显著,能改善糖脂代谢,减轻炎症,降低并发症发生率,且较安全可靠.
Efficacy of pioglitazone hydrochloride and metformin hydrochloride tablets combined with dapagliflozin tablets in treating type 2 diabetes mellitus and effects on glucose and lipid metabolism,serum CRP and MMP-9 levels
Objective:To analyze the efficacy of pioglitazone hydrochloride and metformin hydrochloride tablets in combination with dapagliflozin tablets in the treatment of type 2 diabetes mellitus type 2(T2DM)and the effects on glucose and lipid metabolism,serum C-reactive protein(CRP)and matrix metalloproteinas-9(MMP-9)levels.Methods:A total of 102 patients with T2DM admitted to our hospital from January 2018 to January 2022 were divided into a reference group(treated with pioglitazone hydrochloride and metformin hydrochloride tablets)and a combination group(treated with pioglitazone hydrochloride and metformin hydrochloride tablets + dapagliflozin tablets)with different treatment regimens,with 51 cases in each group.The therapeutic effect after 3 m and the adverse reactions during treatment were observed.Glycosylated hemoglobin(HbAlc)was determined by HPLC before and after treatment.Fasting insulin(FIns)was analyzed by radioimmunoassay.2h postprandial blood glucose(2hPG)and Fasting blood-glucose(FPG)were used to determine postprandial blood glucose.At the same time,the level of Triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL-C)was detected by the endpoint method with the automatic biochemical differentiation instrument.Serum CRP levels were detected by immunoturbidimetry and MMP-9,cystatin c(CysC),and homocysteine(Hcy)levels were detected by enzyme-linked immunosorbent assay.Results:The total effective rate of the combined group was higher than that of the reference group(P<0.05).After treatment,the levels of PG,FPG,HbAlc,and FINs in both groups significantly decreased(P<0.05),with the combination group being more significant(P<0.05).Compared with before treatment,TG,TC,and LDL-C decreased and HDL-C increased in both groups after treatment(P<0.05),with the combination group showing more significant changes(P<0.05).Compared with before treatment,the levels of CRP,MMP-9,CysC,and Hcy in both groups decreased after treatment(P<0.05),with the combination group being more significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the combined group and the reference group(P<0.05).Conclusion:Pioglitazone hydrochloride and metformin hydrochloride tablets combined with dapagliflozin tablets are effective in the treatment of T2DM,which can improve glycolipid metabolism,reduce inflammation and reduce the incidence of complications,and is safe and reliable.
NETL
NSTL
万方数据
