•胰岛素抵抗及其相关疾病•

　　【摘要】 目的 探讨二肽基肽酶(DPP-4)抑制剂沙格列汀联合二甲双胍对T2DM的疗效及其对胰岛β细胞功能的影响。 方法 将75例T2DM患者分为2组，治疗组37例，接受沙格列汀联合二甲双胍治疗，对照(Con)组38例，接受格列美脲联合二甲双胍，观察24周，比较两组治疗前后血糖、HbA1c、胰岛素、胰岛素原水平(pro-Ins)等情况。 结果 两组治疗后FPG、2 hPG，HbA1c较治疗前均下降(P<0.05)，但两组间比较差异无统计学意义;治疗后，治疗组HOMA-β由(37.10±22.70)升至(48.60±26.30),pro-Ins/Ins由(0.43±0.20)降至(0.36±0.19)，BMI由(26.70±6.80)kg/m2降至(25.80±5.90)kg/m2,比较差异均有统计学意义(P均<0.05)。而Con组治疗前后HOMA-β、pro-Ins/Ins及BMI比较，差异均无统计学意义。 结论 沙格列汀在有效降低血糖的同时，不增加体重，对胰岛β细胞有保护作用。

　　【关键词】 糖尿病;二肽基肽酶(DPP-4);沙格列汀

　　【Abstract】 Objective To explore the effects of dipeptidyl peptidase-4 inhibitor saxagliptin therpy on patients with type 2 diabetes and its influence on β-cell function. Methods The 75 patients with type 2 diabetes were divided into two groups: control group (38 cases)were given glimepiride and metformin, and therapy group (37 cases) were given saxagliptin and metformin for 24 weeks. The changes of FPG, HbA1c, Ins and proinsulin-to-insulin ratio levels were observed between the two groups before versus after treatment. Result Posttreatment versus pretreatment Intra-group showed the levels of FPG, 2 hPG and HbA1c were significantly lower(P<0.05),but after treatment, there were no significantly differences in FPG, 2 hPG and HbA1c between two groups. The levels of HOMA-β were significant increased from(37.1±22.7) to (48.6±26.3),the proinsulin/insulin ratio were reduced from (0.43±0.2) to (0.36±0.19) and BMI were reduced from (26.7±6.8)kg/m2 to (25.8±5.9)kg/m2 in therapy group (P<0.05)，but the levels of those in control group had no statistical difference. Conclusion Saxagliptin added to ongoing metformin therapy is efficacious and β-Cell function is improved in patients with type 2 diabetes.

　　【Key words】 Diabetes mellitus ;Dipeptidyl;Peptidase-4;Saxagliptin