【摘要】 目的  探讨利格列汀联合二甲双胍治疗新诊断T2DM患者的临床疗效及安全性。 方法  采用随机数值表法将我院内分泌科2013年1～10月收治的140例新诊断T2DM患者分为利格列汀组（利格列汀+二甲双胍）和格列吡嗪组（格列吡嗪+二甲双胍），各70例，疗程均为12周.比较两组降糖效果及安全性。 结果  治疗前后两组FPG、2 hPG及HbA₁c比较,差异无统计学意义（P>0.05）；治疗后两组FPG、2 hPG及HbA₁c较治疗前降低（P<0.05），治疗后两组间比较差异无统计学意义（P>0.05）。治疗前两组FC-P、2 hC-P、稳态模型评估胰岛素β细胞功能指数（HOMA-β）、胰岛素抵抗指数（HOMA-IR）、胰岛素作用指数（IAI）及APN水平比较,差异均无统计学意义（P>0.05）；治疗后两组较治疗前均好转（P<0.05），且利格列汀组优于格列吡嗪组（P<0.05）。格列吡嗪组治疗不良反应(18.57%)高于利格列汀组(5.71%)（χ²=5.423，P=0.020）。 结论  利格列汀联合二甲双胍治疗新诊断T2DM有与格列吡嗪联合二甲双胍相同的降糖效果，且前者对胰岛β细胞功能具有更好的保护作用，同时有利于提高APN水平。

【关键词】 利格列汀；二甲双胍；糖尿病，2型；临床疗效

Efficacy and βcell function improvement of linagliptin in combination with oral hypoglycemic agents in      newly diagnosed T2DM patients

    【Abstract】  Objective   To explore the efficacy and safety of linagliptin in combination with metformin in newly dia-gnosed T2DM patients.   Methods    A total of 140 newly diagnosed T2DM patients were enrolled in this study. All the pa-tients were admitted in the Endocrinology and Metabolism department of our hospital  from January 2013 to October 2013. Random number table method was used in patients’ selection. All the patients were divided into two groups: linagliptin plus metformin group (linagliptin group, n=70) and glipizide plus metformin group (glipizide group, n=70), and followed up for 12 weeks. Efficacy and safety of treatment were compared between the two groups.   Results    The difference of FPG, 2h-FPG and HbA1c did not reach the statistical significance between the two groups at baseline and after treatment (P>0.05). FPG,

2h-FPG and HbA1c were significantly lower after treatment compared with baseline in both groups (P<0.05). FC-P, 2hC-P, HOMA-beta, HOMA-IR, IAI and adiponectin level at baseline were similar between the two groups (P>0.05). All these indi-cators were improved after treatment in both groups (P<0.05), and were significant better in linagliptin group than in gli-pizide group. Adverse events rate were significantly higher in glipizide group than in linagliptin group (18.57% vs 5.71%

χ2=5.423，P=0.020).   Conclusion    The efficacy of linagliptin in combination with metformin in newly diagnosed T2DM patients was similar with glipizide plus metformin. The βcell function improvement was better and APN level was higher after Linagliptin treatment.

    【Key  words】  Linagliptin; Metformin; type 2 diabetes; clinical effect