沙格列汀治疗单用二甲双胍治疗血糖控制不佳2型糖尿病患者疗效及[摘要]目的探索沙格列汀?Χ?甲双胍单药治疗血糖控制不佳2型糖尿病患者的安全性及有效性。方法选择2015年1月―2016年12月在该院内分泌科门诊及住院的糖尿病患者252例。将入选患者按照1：1的比例随机分配至沙格列汀组或者阿卡波糖组。两组患者均继续维持二甲双胍治疗，沙格列汀组患者在原降糖方案的基础上加用沙格列汀片5mg/d，1次/d；阿卡波糖组加用阿卡波糖50mg，3次/d。随访观察期24周。每4周随访1次。观察两组患者治疗前后的FPG、2hPG、HbA1c的变化，并记录随访期间药物相关不良事件发生情况。比较上述指标的在两组的变化。结果①沙格列汀组与阿卡波糖组治疗后FPG、2hPG较该组治疗前均有明显降低（P<0.05）；与阿卡波糖组治疗后相比，沙格列汀组2hPG显著下降，差异有统计学意义（P<0.05）；②干预24周后，沙格列汀组与阿卡波糖组各组HbAlc均有降低（P<0.05）；与阿卡波糖组相比，沙格列汀组HbAlc下降幅度更大（P<0.05）；沙格列汀组HbA1c达标率为48.82%显著高于阿卡波糖组的35.20%，差异有统计学意义（P<0.05）。③随访期间，阿卡波糖组胃肠道异常发生率高于沙格列汀组（16.80%vs3.94%，P<0.05）；沙格列汀组与阿卡波糖组的低血糖事件和因不良事件而终止者相比较差异无统计学意义（7.09%vs6.40%、5.51%vs4.80%，P>0.05）。结论对于二甲双胍单药治疗血糖不达标的2型糖尿病患者，加用沙格列汀可有效降糖，提高糖化血红蛋白达标率，且不增加低血糖和胃肠道反应风险。[关键词]二肽基肽酶抑制剂；沙格列汀；2型糖尿病[]R587[文献标识码]A[]1672-4062（2017）05（b）-0103-03[Abstracts]ObjectiveThispapertriestoassesstheefficacyandsafetyofsaxagliptinonpatientswithtype2diabeteswithinadequateglycemiccontrolofmetformin.Methods252patientswithtype2diabetesinthishospitalfromJanuary2015toDecember2016wereenrolledinthestudy.Patientswererandomlyassignedtothesaxagliptingroupandacarbosegroupata1：1ratio.Thepatientsinthetwogroupsweretreatedwithmetformin，andthepatientsinthesaxagliptingroupweretreatedwithsaxagliptintablets5mgperdayandonetimeaday.Theacarbosegroupwastreatedwithacarbose50mg，3aday.Follow-upobservationperiodlastedfor24weeks，withonefollow-upinevery4weeks.ThechangesofFPG，2hPGandHbA1cbeforeandaftertreatmentwereobservedandtheincidenceofdrug-relatedadverseeventsduringthefollow-upwasrecorded.Thechangesoftheaboveindicatorsinthetwogroupswerecompared.Results①ThelevelsofFPGand2hPGinthesaxagliptingroupandacarbosegroupaftertreatmentsignificantlydecreasedcomparedwiththatbeforethetreatment（P<0.05）.the2hPGlevelofthesaxagliptingroupdecreasedmoreobviouslythanthatoftheacabosegroupaftertreatment（P<0.05）.②After24weeksofintervention，thelevelsofHbA1cinthetwogroupsweresignificantlydecreased（P<0.05），andthatofthesaxagliptingroupdecreasedmorethanthatoftheacarbosegroup（P<0.05），theHbA1clevelofthesaxagliptingroupwas48.82%，significantlyhigherthantheacarbosegroupof35.20%andthedifferencewasstatisticallysignificant（P<0.05）.③Duringthefollow-upperiod，theincidenceofgastrointestinalabnormalitiesintheacarbosegroupwashigherthanthatinthesaxagliptingroup（16.80%vs3.94%，P<0.05）；Therewasnosignificantdifferencebetweenthetwogroupsinincidencesofhypoglycemiaandotheradverseevents（7.09%vs6.40%，5.51%vs4.80%，P>0.05）.ConclusionForpatientswithtype2diabetesofinadequatelycontrolledwithmetformin，theapplicationofsaxagliptincanbeeffectivelycontroltheglucose，increasetheglycosylatedhemoglobincompliancerate，andwillnotincreasetheriskofhypoglycemiaandgastrointestinalreactions.[Keywords]Dipeptidylpeptidaseinhibitor；Saxagliptin；Type2diabetes糖尿病对公共健康的整体负面...