【摘要】 目的 观察沙格列汀联合持续皮下输注胰岛素对胰岛β细胞功能较差的T2DM患者血糖波动的影响。 方法 选取胰岛功能较差的T2DM患者30例采用持续皮下输注胰岛素治疗15 d，第10天后胰岛素剂量不再调整，第13天晨起开始口服沙格列汀，最后5 d采用动态血糖监测系统(CGMS)监测血糖，比较第11~12天和第14~15天平均血糖波动幅度(MAGE)、血糖水平标准差(SDBG)、平均血糖水平(MBG)、血糖>10.0 mmol/L的时间百分率(PT10.0)、血糖<3.9 mmol/L的时间百分率(PT3.9)的变化。 结果 与口服沙格列汀前相比，口服沙格列汀后MAGE[(5.28±1.44) vs (3.27±0.76)mmol/L]、SDBG[(2.43±0.50) vs (1.79±0.45)mmol/L]、MBG[(8.05±1.01) vs (6.94±0.72)mmol/L]、PT10.0 [(11.69±4.18)% vs (4.03±2.50)%]下降 (P<0.01)，PT3.9[(4.07±3.00)% vs (4.72±2.66)%]变化比较差异无统计学意义。 结论 沙格列汀联合持续皮下输注胰岛素可改善胰岛功能较差的T2DM患者血糖波动，且不增加低血糖事件发生。

　　【关键词】沙格列汀;动态血糖监测系统;血糖波动;糖尿病，2型

　　【Abstract】 Objective To assess the evaluation of efficacy of saxagliptin on blood glucose fluctuations by means of continuous glucose monitoring system (CGMS) in long-course T2DM patients with poor β-cell function. Methods Thirty T2DM patients with poor β-cell function were treated with insulin-pump for fifteen days. The insulin dose was not adjusted after the tenth day, and saxagliptin was add-on on the morning of the thirteenth to fifteenth days. CGMS was performed for the last five days. The mean amplitude of glycaemic excursion (MAGE), standard deviation of blood glucose (SDBG) and mean blood glucose (MBG), percentage period of hyperglycemia (glucose>10.0 mmol/L) (PT10.0), percentage period of hypoglycemia (glucose<3.9 mmol/L) (PT3.9) of the patients on the eleventh to twelfth and fourteenth to fifteenth were compared. Results Compared with before administration of saxagliptin, the levels of MAGE [(5.28±1.44) vs (3.27±0.76)mmol/L], SDBG [(2.43±0.50) vs (1.79±0.45)mmol/L], MBG [(8.05±1.01) vs (6.94±0.72)mmol/L], PT10.0 [(11.69±4.18)% vs (4.03±2.50)%] decreased (P<0.01). There was no significant difference on PT3.9 [(4.07±3.00)% vs (4.72±2.66)%]. Conclusion Adding saxagliptin on long-course T2DM patients with poor β-cell function receiving insulin-pump therapy is effective for improving glucose fluctuations without increasing the incidence of hypoglycemic events.

　　【Key words】Saxagliptin;Continuous glucose monitoring system (CGMS);Glucose fluctuations;Diabetes mellitus，type 2