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目的:观察单用口服降糖药效果不佳的高龄患者联用磷酸西格列汀治疗的疗效及安全性。方法:120例年龄≥75岁、血糖控制不理想的2型糖尿病老年患者,根据所服降糖药种类分为4组,在单药治疗方案的基础上加用西格列汀100 mg·d~(-1),治疗20周.观测患者空腹、餐后血糖、C肽及糖化血红蛋白,以及肝肾功能、体重指数等指标的变化。结果:四组患者空腹、餐后血糖及糖化血红蛋白均较治疗前明显降低(P<0.05),C肽较前变化不明显(P>0.05),肝肾功能和体重指数均无明显变化(P>0.05)。4组间各项指标比较差异无统计学意义(P>0.05)。治疗期间,6例患者感腹胀,其中1例因腹胀停用西格列汀退出。结论:经单药治疗高龄2型糖尿病血糖控制不理想的患者,联用西格列汀可使血糖控制满意,耐受良好。
Objective: To observe the efficacy and safety of combined treatment with sitagliptin phosphate in elderly patients with poor oral hypoglycemic agents. Methods: A total of 120 elderly patients with type 2 diabetes who were over 75 years old and whose blood glucose control was not satisfactory were divided into 4 groups according to the types of hypoglycemic agents they used. On the basis of the single drug regimen, sitagliptin 100 mg · d ~ (-1) for 20 weeks.Observation of fasting, postprandial blood glucose, C-peptide and glycosylated hemoglobin, and liver and kidney function, body mass index and other indicators of change. Results: The fasting, postprandial blood glucose and glycosylated hemoglobin in the four groups were significantly lower than those before treatment (P <0.05), C peptide was not significantly changed (P> 0.05), and liver and kidney function and body mass index had no significant change (P > 0.05). There was no significant difference among the four groups (P> 0.05). During treatment, 6 patients had bloating, and 1 of them discontinued sitagliptin due to bloating. CONCLUSIONS: Patients treated with monotherapy for advanced type 2 diabetes with poor glycemic control may be treated with sitagliptin in a satisfactory and well tolerated manner.