目的 探討恩格列凈聯(lián)合格列齊特治療2型糖尿病的臨床效果。方法 選取2019年5月—2021年5月秦皇島軍工醫(yī)院收治的126例2型糖尿病患者，隨機(jī)分為對(duì)照組和治療組，每組各63例。對(duì)照組早餐口服格列齊特緩釋片，30 mg/次，1次/d。在對(duì)照組基礎(chǔ)上，治療組口服恩格列凈片，10 mg/次，1次/d。兩組患者連續(xù)治療12周。觀察兩組患者臨床療效，比較治療前后兩組患者血糖指標(biāo)、李光偉指數(shù)和修正的胰島β細(xì)胞功能指數(shù)（MBCI），及血清心鈉素（ANP）、內(nèi)皮素-1（ET-1）、丙二醛（MDA）和基質(zhì)金屬蛋白酶-9（MMP-9）水平。結(jié)果 治療后，治療組降糖有效率（95.24%）較對(duì)照組（84.13%）顯著提高（P＜0.05）。治療后，兩組空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血紅蛋白（HbA1c）比治療前均顯著下降（P＜0.05），且以治療組的降低更顯著（P＜0.05）。治療后，兩組李光偉指數(shù)、MBCI均較治療前顯著升高（P＜0.05），且均以治療組的改善更顯著（P＜0.05）。相比治療前，治療后兩組血清ANP水平均顯著升高，血清ET-1、MDA和MMP-9水平均顯著降低（P＜0.05）；治療后，治療組血清ANP、ET-1、MDA和MMP-9水平均顯著好于對(duì)照組（P＜0.05）。結(jié)論 恩格列凈聯(lián)合格列齊特治療2型糖尿病能安全有效且平穩(wěn)地控制患者血糖水平，改善胰島β細(xì)胞功能，增強(qiáng)胰島素敏感性。

Objective To investigate the clinical effect of empagliflozin combined with gliclazide in treatment of type 2 diabetes mellitus. Methods Patients (126 cases) with type 2 diabetes mellitus in Qinhuangdao Military Hospital from May 2019 to May 2021 were randomly divided into control and treatment group, and each group had 63 cases. Patients in the control group were po administered with Gliclazide Modified Release Tablets, 30 mg/time, once daily. Patients in the treatment group were po administered with Empagliflozin Tablets on the basis of the control group, 10 mg/time, once daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical evaluation was evaluated, the blood glucose indexes, Li Guangwei index and MBCI, and the levels of ANP, ET-1, MDA and MMP-9 in two groups before and after treatment were compared. Results After treatment, the effective rate of hypoglycemia in the treatment group (95.24%) was significantly higher than that in the control group (84.13%) (P < 0.05). After treatment, FPG, 2 h PG and HbA1c were significantly decreased in two groups (P < 0.05), especially in the treatment group (P < 0.05).After treatment, Li Guangwei index and MBCI in two groups were significantly higher than those before treatment (P < 0.05), and the improvement in the treatment group was more significant (P < 0.05). Compared with those before treatment, the levels of serum ANP were significantly increased and the concentrations of serum ET-1, MDA and MMP-9 were significantly decreased in two groups after treatment (P < 0.05), but the levels of serum ANP, ET-1, MDA and MMP-9 in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Empagliflozin combined with gliclazide in treatment of type 2 diabetes mellitus can safely, effectively and smoothly control the blood glucose level of patients, improve islet β-cell function and enhance insulin sensitivity.

R977

河北省衛(wèi)健委科研基金項(xiàng)目(20191705)