目的:探讨DPP-4抑制剂联合二甲双胍对2型糖尿病合并代谢综合征患者糖脂代谢、微炎症状态的影响。方法:选择在我科接受治疗的2型糖尿病合并代谢综合征患者60例,随机分为对照组、观察组各30例。对照组接受单独二甲双胍治疗,观察组接受DPP-4抑制剂联合二甲双胍治疗,对比两组的治疗前后糖脂代谢指标、炎症因子水平的差异。结果:治疗前,两组外周血中糖脂代谢指标水平、血清中炎症因子含量的差异无统计学意义(P＞0.05)。治疗后,观察组外周血中糖代谢指标FPG、FPI、HOMA-IR的及脂质代谢指标TG、TC的含量低于对照组,HDL-C的含量高于对照组；血清中炎症因子IL-6、CRP、TNF-α的含量低于对照组(P<0.05)。结论:2型糖尿病合并代谢综合征患者接受DPP-4抑制剂联合二甲双胍治疗,能够更为有效的控制机体糖脂代谢进程,并抑制微炎症状态。

Objective: To study the effect of DPP-4 inhibitor combined with metformin on glucose and lipid metabolism and micro-inflammatory state in patients with type 2 diabetes mellitus complicated by metabolic syndrome. Methods: 60 patients with type 2 diabetes mellitus complicated by metabolic syndrome who were treated in the hospital between February 2015 and December 2016 were divided into control group (n=30) and observation group (n=30) according to the random number table method. Control group received metformin therapy alone, observation group received DPP-4 inhibitor combined with metformin therapy, and the differences in levels of glucose and lipid metabolism indexes and inflammatory factors were compared between the two groups of patients before and after treatment. Results:Before treatment, the differences in glucose and lipid metabolism index levels in peripheral blood as well as inflammatory factor contents in serum were not statistically significant between the two groups(P＞0.05). After treatment, the levels of glucose metabolism indexes FPG, FPI and HOMA-IR as well as lipid metabolism indexes TG and TC in peripheral blood of observation group were lower than those of control group while HDL-C level was higher than that of control group;the contents of inflammatory factors IL-6, CRP and TNF-α in serum were lower than those of control group (P<0.05). Conclusion: DPP-4 inhibitor combined with metformin therapy is more effective in controlling the glucose and lipid metabolism process and inhibiting the micro-inflammatory state in patients with type 2 diabetes mellitus complicated by metabolic syndrome.

R587.1

2013湖北省卫计委面上项目(JX6B105)