目的 探讨维格列汀联用二甲双胍对2型糖尿病患者血糖控制效果及富含半胱氨酸的酸性分泌蛋白(SPARC)表达的影响.方法 选取2013年12月至2015年12月在天津市滨海新区大港中医医院就诊的2型糖尿病患者120例,采用随机数字法分为对照组和观察组,各60例.对照组口服二甲双胍(0.5 g/d)进行治疗;观察组口服二甲双胍(0.5 g/d)联合维格列汀(50 mg/d)进行治疗.对两组患者治疗前后血糖控制效果及SPARC表达变化进行分析比较.结果 治疗后,观察组空腹血糖、餐后2 h血糖以及糖化血红蛋白均低于对照组[(7.24±2.59) mmol/L比(8.56±1.97) mmol/L,(5.04±0.33)%比(6.88±0.07)%,(13.62±0.87) mmol/L比(15.41±0.98) mmol/L](P<0.01).治疗后,观察组尿糖低于对照组[(13.62±0.87) mmol/L比(15.41±0.98) mmol/L](P<0.01).治疗后,观察组餐后C肽及SPARC水平均低于对照组[(4.61±1.42) μg/L比(5.51±1.81) μg/L,(3.89±0.77) μg/L 比(4.85±0.48) μg/L](P<0.01).观察组低血糖发生率低于对照组[3.3%(2/60)比15.0%(9/60)](P<0.05).%Objective To observe the effect of vildagliptin with metformin on glycemic control and the expression of secreted protein acidic and rich in cysteine (SPARC) in type 2 diabetes.Methods A total of 120 patients with type 2 diabetes in Tianjin Binhai New Area Dagang Chinese Medicine Hospital during Dec.2013 and Dec.2015 were divided into two groups:50 mg/d vildagliptin with 0.5 g/d metformin were used in the observation group,while the control group was treated with 0.5 g/d metformin.The glycemic and SPARC expression of the two groups were analyzed and compared.Results The fasting plasma glucose,postprandial 2 h plasma glucose,glycosylated hemoglobin,urine glucose after treatment in the observation group were lower than those of the control group[(7.24±2.59) mmol/L vs (8.56±1.97) mmol/L,(5.04±0.33)% vs (6.88±0.07)%,(13.62±0.87) mmol/L vs (15.41±0.98) mmol/L,(13.62±0.87) mmol/L vs (15.41±0.98) mmol/L](P<0.01).The postprandial C peptide,SPARC expression after treatment in the observation group were lower than those of the control group[(4.61±1.42) μg/L vs (5.51±1.81) μg/L,(3.89±0.77) μg/L vs (4.85±0.48) μg/L](P<0.01).The incidence of hypoglycemia in the observation group was lower than that of the control group[3.3%(2/60) vs 15.0%(9/60)](P<0.05).Conclusion Metformin plus vildagliptin treatment of type 2 diabetes,is featured with good glycemic control,lower expression of SPARC and lower incidence of hypoglycemia.
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