目的 研究達格列凈聯(lián)合西格列汀治療脆性2型糖尿病患者的臨床療效。方法 將2017年7月—2019年7月延安大學附屬醫(yī)院收治的80例脆性2型糖尿病患者作為研究對象，將患者隨機分為對照組和觀察組，每組各40例。對照組口服磷酸西格列汀片治療，100 mg/d。觀察組在對照組基礎上口服達格列凈片，10 mg/d。兩組療程為12周。比較兩組治療前后的空腹血糖（FBG）、餐后2 h血糖（2 h PG）、糖化血紅蛋白（HbAlc）、日間血糖平均絕對差（MODD）、餐后血糖波動幅度（PPGE）、白細胞介素-4（IL-4）、白細胞介素-6（IL-6）、腫瘤細胞壞死因子（TNF）-α水平。結果 治療后，兩組患者FBG、2 h PG、HbA1c均顯著降低（P<0.05），且觀察組FBG、2 h PG、HbA1c顯著低于對照組（P<0.05）。治療后，兩組患者MODD和PPGE均顯著低于治療前（P<0.05），且觀察組MODD和PPGE明顯低于對照組（P<0.05）。治療后，兩組患者IL-4、IL-6、TNF-α水平均顯著降低（P<0.05），且觀察組炎性因子水平顯著低于對照組（P<0.05）。結論 達格列凈聯(lián)合西格列汀能起到協(xié)同作用，有效控制脆性2型糖尿病患者的血糖水平，降低炎性因子水平，減少血糖波動與低血糖的風險。

Objective To study the clinical effect of dapagliflozin combined with sitagliptin on patients with fragile type 2 diabetes. Methods A total of 80 patients with fragile type 2 diabetes admitted to Yan'an University Affiliated Hospital from July 2017 to July 2019 were randomly divided into control group and an observation group, with 40 patients in each group. Patients in the control group were po administered with Sitagliptin Phosphate Tablets for 100 mg/d. Patients in the observation group were po administered with Dapagliflozin Tablets on the basis of the control group, 10 mg/d. The course of treatment in both groups was 12 weeks. After treatment, the levels of FBG, 2 h PG, HbAlc, MODD, PPGE, IL-4, IL-6, and TNF-α before and after treatment were compared between two groups. Results After treatment, FBG, PG and HbA1c in two groups were significantly reduced (P<0.05), and FBG, PG and HbA1c in the observation group were significantly lower than those in the control group (P<0.05). After treatment, MODD and PPGE in two groups were significantly lower than those before treatment (P<0.05), and MODD and PPGE in the observation group were significantly lower than those of the control group (P<0.05). After treatment, the levels of IL-4, IL-6 and TNF-α in two groups were significantly decreased (P<0.05), and the inflammatory factors in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Dapagliflozin combined with sitagliptin can play a synergistic role in effectively controlling blood glucose levels in patients with fragile 2 diabetes, reducing inflammatory factor levels, and reducing the risk of blood glucose fluctuations and hypoglycemia.

R977