·糖尿病临床研究·

　　贾 贺、韩 萍

　　作者单位：110004沈阳，中国医科大学附属盛京医院内分泌科

　　【摘要】目的  系统评价格列美脲与格列本脲治疗T2DM的疗效。方法  计算机检索 PubMed、万方等数据库从建库至2010年12月间的有关文献。按Cochrane系统评价的方法评价纳入研究的质量，使用Review Manager4.2软件进行荟萃分析。结果共纳入9个随机对照试验。  结果  显示：格列美脲在降低HbA1c[P=0.08，加权均数差(WMD)=-0.18，95%CI(-0.39，0.02)]、FPG[P=0.06，WMD=-0.46，95%CI(-0.94，0.01)]、餐后血糖[P=0.73，WMD=-0.16，95%CI(-1.08，0.76)]、TC[P=0.22，WMD=-0.2,95%CI(-0.51 ,0.12)]和TG[P=0.06，WMD=-0.30,95%CI(-0.61,0.01)]方面与格列本脲无差异;在相同血糖水平下，格列美脲组FIns[P<0.05，WMD=-0.83，95%CI(-1.21，0.45)]及餐后胰岛素[P<0.05，WMD=-5.94，95%CI(-8.79，-3.10)]升高程度低于格列本脲组;低血糖发生率格列美脲组低于格列本脲组[P<0.05，RR=0.66，95%CI(0.53，0.81)];在降低BMI方面格列美脲优于格列本脲[P=0.02，WMD=-1.49，95%CI(-2.7，-0.27)]。结论  与格列本脲相比，格列美脲在降低血糖的同时，还能改善胰岛素抵抗及减轻体重，且低血糖发生率低，是安全有效的治疗T2DM的药物。

　　【关键词】格列美脲;格列本脲;糖尿病，2型;荟萃分析

　　doi:10.3969/j.issn.1006-6187.2011.12.013

　　Glimepiride versus glibenclamide treatment of type 2 diabetes mellitus: A systematic evaluationJIA He, HAN Ping.Department of Endocrinology, Shengjing Hospital Affiliated to China Medical University, Shenyang 110004, China

　　【Abstract】Objective   To assess glimepiride versus glibenclamide treatment of type 2 diabetes mellitus (T2DM). Methods   We searched the literatures from PubMed, Wanfang and other databases. Evaluating the quality of the study was performed according to Cochrane systematic reviews, and Meta-analysis was completed by software Review Manager 4.2. Results    Nine RCTs (randomized control trials) were included in the analysis. There were no differences between two groups in decrements of glycosylated hemoglobin[P=0.08，the weighted mean difference (WMD)=-0.18，95%CI(-0.39，0.02)], of fasting plasma glucose [P=0.06，WMD=-0.46，95%CI(-0.94，0.01)] and postprandial plasma glucose[P=0.73，WMD=-0.16，95%CI(-1.08，0.76)], of cholesterol[P=0.22，WMD=-0.2 ,95%CI(-0.51,0.12)] and of triglyceridel[P=0.06，WMD=-0.30 ,95%CI(-0.61,0.01)].Under the same glucose level, glimepiride showed less increment of both fasting plasma insulin [P<0.05，WMD=-0.83，95%CI(-1.21，0.45)] and postprandial plasma insulin[P<0.05，WMD=-5.94，95%CI(-8.79，-3.10)] than glibenclamide . There was a lower incidence of hypoglycemia[P<0.05，RR=0.66，95%CI(0.53，0.81)] in glimepiride group than in glibenclamide group.Glimepiride had less increment of BMI[P=0.02，WMD=-1.49，95%CI(-2.7，-0.27)] than glibenclamide.Conclusion   In comparison to glibenclamide, glimepiride can not only reduce blood glucose,but improve insulin resistance.It can also reduce body weight increment and has less hypoglycemia.

　　【Key words】Glimepiride; Glibenclamide;Diabetes mellitus, type 2; Meta-analysis