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目的观察艾塞那肽对2型糖尿病患者C肽的影响及临床疗效。方法选取2012年1月至2013年6月在新桥医院内分泌科住院的2型糖尿病患者78例,分为治疗组(n=39),给予二甲双胍联合艾塞那肽治疗,包括男性16例,女性23例,年龄(49.0±6.0)岁;对照组(n=39),给予二甲双胍联合甘精胰岛素治疗,包括男性21例,女性18例,年龄(50.1±5.9)岁。两组均治疗16周。监测并分析两组治疗前后空腹及餐后2 h C肽、空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2-hour postprandial blood glucose,2hPG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、体质量指数(BMI)等相关指标的变化。结果治疗16周后治疗组空腹及餐后2 h C肽水平[(2.34±0.51)、(2.66±0.99)ng/mL]均较治疗前[(1.89±0.63)、(1.09±0.46)ng/mL]有所增高(P<0.05),但对照组C肽治疗前后无明显变化(P>0.05);两组患者治疗后的FBG、2hPG、HbA1c[治疗组治疗后分别为(6.94±0.75)、(9.98±0.85)mmol/L,(6.87±0.89)%]均较治疗前[治疗组治疗前分别为(10.06±1.98)、(12.3±0.75)mmol/L,(8.89±1.15)%]有所降低(P<0.05),且两组之间差异无统计学意义(P>0.05);两组患者体质量、腹围及BMI均较治疗前有所下降,治疗组降低更明显(P<0.05)。结论艾塞那肽联合二甲双胍在提高2型糖尿病患者的C肽水平的同时能够降低患者的血糖、HbA1c、体质量、腹围及BMI。
Objective To observe the effect of exenatide on C-peptide in type 2 diabetic patients and its clinical efficacy. Methods From January 2012 to June 2013, 78 patients with type 2 diabetes admitted to Department of Endocrinology, Xinqiao Hospital were divided into treatment group (n = 39), metformin combined with exenatide, including 16 males, There were 23 males and 49.0 ± 6.0 years of age. The control group (n = 39) was treated with metformin plus insulin glargine, including 21 males and 18 females, aged 50.1 ± 5.9 years. Both groups were treated for 16 weeks. The fasting and postprandial 2-hour C-peptide, fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c) , Body mass index (BMI) and other related indicators of change. Results After 16 weeks of treatment, the fasting and postprandial 2-h C-peptide levels in the treatment group were significantly higher than those before treatment [(1.89 ± 0.63), (1.09 ± 0.46) ng / (P <0.05), but there was no significant change in the control group before and after C-peptide treatment (P> 0.05). FBG, 2hPG and HbA1c after treatment in the two groups were (6.94 ± 0.75) , (9.98 ± 0.85) mmol / L, (6.87 ± 0.89)%, respectively) were significantly higher than those before treatment [(10.06 ± 1.98), (12.3 ± 0.75) mmol / (P <0.05), and there was no significant difference between the two groups (P> 0.05). The body weight, abdominal circumference and BMI in both groups decreased compared with that before treatment, and the treatment group decreased more obviously <0.05). Conclusion Exenatide combined with metformin can improve the level of C-peptide in patients with type 2 diabetes mellitus and reduce the blood glucose, HbA1c, body mass, abdominal circumference and BMI.