·糖尿病临床研究·

　　作者单位：315020宁波大学医学院附属医院内分泌科

　　二甲双胍联合DPP-4抑制剂与二甲双胍单药治疗2型糖尿病的疗效比较

　　赵廷启 王黎明

　　【摘要】目的探讨对新诊断T2DM患者给予二肽基肽(DPP-4)抑制剂联合口服药降糖方案的有效性及安全性。方法收集200例新诊断T2DM患者，随机分为观察组和对照组，对照组采用二甲双胍常规治疗，观察组加用DPP-4抑制剂，随访24周，观察FPG、2 hPG和HbA1c等有效性指标及BMI，低血糖发生情况。结果观察组治疗后FPG和HbA1c相较于对照组显著下降(P<0.05)，观察组HbA1c达标率为85%显著高于对照组的72%(P<0.05)，两组治疗后BMI及低血糖发生率无显著差异(P>0.05)。结论DPP-4抑制剂与二甲双胍联用治疗T2DM降糖效果更好，对体重无影响，不会增加低血糖风险。

　　【关键词】DPP-4抑制剂;二甲双胍;糖尿病，2型

　　doi:10.3969/j.issn.1006-6187.2012.05.015

　　Therapeutic comparison between pure metformin and DPP-4 inhibitor as add-on therapy to metformin in T2DM treatmentZHAO Ting-qi, WANG Li-ming. Department of Endocrinology, The Affiliated Hospital of Ningbo University, Ningbo 315020, China

　　【Abstract】ObjectiveTo investigate the therapeutic comparison between pure metformin and DPP-4 inhibitors as add-on therapy to metformin in the newly diagnosed T2DM patients.MethodsThe 200 newly diagnosed T2DM patients were randomized into observation group and control group. Both of the two groups were given metformin while the observation group was administered DPP-4 inhibitors additionally for 24 weeks. The fasting plasma glucose(FPG), two-hour postprandial plasma glucose(2 hPG), hemoglobin A1c(HbA1c), body mass index(BMI), and the incidence of hypoglycemia in both groups were observed.ResultsCompared with the control group, the levels of FPG, 2 hPG, and HbA1c decreased significantly in the observation group(P<0.05). The targeting rate of HbA1c was 85% in the observation group, significantly higher than 72% in the control group(P<0.05). The change in BMI and the incidence of hypoglycemia of the two groups were not significantly different(P>0.05).ConclusionThe combination of metformin with DPP-4 inhibitors is more effective for the treatment of T2DM, without influence on the body weight, and without increased risk for incidence of hypoglycemia.

　　【Key words】DPP-4 inhibitors; Metformin; Diabetes mellitus, type 2