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预防医学  2025, Vol. 37 Issue (10): 1054-1058    DOI: 10.19485/j.cnki.issn2096-5087.2025.10.016
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2型糖尿病患者西格列汀联合二甲双胍与门冬胰岛素联合二甲双胍干预效果比较
杨丽雅, 杜厉英, 张亚当, 姜灵芝
金华市中心医院,浙江 金华 321000
Comparison of intervention effects between sitagliptin combined with metformin and insulin aspart combined with metformin among patients with type 2 diabetes mellitus
YANG Liya, DU Liying, ZHANG Yadang, JIANG Lingzhi
Jinhua Centeral Hospital, Jinhua, Zhejiang 321000, China
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摘要 目的 比较2型糖尿病(T2DM)患者西格列汀联合二甲双胍与门冬胰岛素联合二甲双胍的干预效果,为优化T2DM患者血糖控制策略提供参考。方法 选择2018年1月—2024年12月金华市中心医院内分泌科收治的T2DM患者为研究对象,采用倾向评分匹配法按1∶1比例分为西格列汀联合二甲双胍组和门冬胰岛素联合二甲双胍组;通过问卷调查、体格检查和实验室检测收集两组患者基本信息、毛细血管血糖、糖化血红蛋白(HbA1c)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG)、体质指数(BMI)、收缩压(SBP)和舒张压(DBP)等资料;采用广义估计方程分析两组患者治疗前后各项指标变化,比较干预效果。结果 西格列汀联合二甲双胍组69例,男性42例,占60.87%;女性27例,占39.13%;年龄<60岁42例,占60.87%。门冬胰岛素联合二甲双胍组69例,男性47例,占68.12%;女性22例,占31.88%;年龄<60岁45例,占65.22%。两组患者性别、年龄、文化程度、吸烟、饮酒、蔬菜水果摄入量和病程比较,差异无统计学意义(均P>0.05)。治疗6个月后,两组患者毛细血管血糖、HbA1c的组间与时间存在交互作用(均P<0.05),西格列汀联合二甲双胍组患者毛细血管血糖、HbA1c下降幅度大于门冬胰岛素联合二甲双胍组。两组患者TC、HDL-C、TG、BMI、SBP和DBP的组间差异、时间差异无统计学意义,且组间与时间不存在交互作用(均P>0.05)。结论 西格列汀联合二甲双胍控制T2DM患者血糖的效果优于门冬胰岛素联合二甲双胍。
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杨丽雅
杜厉英
张亚当
姜灵芝
关键词 西格列汀门冬胰岛素二甲双胍2型糖尿病广义估计方程    
AbstractObjective To compare the intervention effects of sitagliptin combined with metformin and insulin aspart combined with metformin among patients with type 2 diabetes mellitus (T2DM), so as to provide the reference for optimizing blood glucose control strategies among patients with T2DM. Methods T2DM patients admitted to the department of endocrinology of Jinhua Central Hospital from January 2018 to December 2024 were selected as the research objects. According to the propensity score matching, T2DM patients were divided into sitagliptin combined with metformin group and insulin aspart combined with metformin group at a ratio of 1∶1. The basic information, capillary blood glucose, glycosylated hemoglobin blood glucose (HbA1c), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglyceride (TG), body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the two groups were collected by questionnaire survey, physical examination and laboratory test. The generalized estimating equation was used to analyze the changes of various indicators before and after treatment between the two groups of patients, and the intervention effect was compared. Results There were 69 cases in the sitagliptin combined with metformin group. Among these 42 cases were males, accounting for 60.87%, and 27 cases were females, accounting for 39.13%.Forty-two cases were younger than 60 years, accounting for 60.87%. There were 69 cases in the insulin aspart combined with metformin group. Among these 47 cases were males, accounting for 68.12%, and 22 cases were females, accounting for 31.88%. Forty-five cases were younger than 60 years, accounting for 65.22%. There were no statistically significant differences in gender, age, education level, smoking, drinking, vegetable and fruit intake, and disease duration between the two groups (all P>0.05). After 6 months of treatment, there was an interaction between group and time in capillary blood glucose and HbA1c in the two groups (all P<0.05), and the reduction of capillary blood glucose and HbA1c in the sitagliptin combined with metformin group was greater than that in the insulin aspart combined with metformin group. There were no statistically significant differences between groups and time in TC, HDL-C, TG, BMI, SBP, and DBP, and no interaction effect was found between groups and time (all P>0.05). Conclusion Sitagliptin combined with metformin is more effective than insulin aspart combined with metformin in controlling blood glucose among patients with T2DM.
Key wordssitagliptin    insulin aspart    metformin    type 2 diabetes mellitus    generalized estimating equation
收稿日期: 2025-06-09      修回日期: 2025-08-25     
中图分类号:  R587.1  
基金资助:浙江省医药卫生科技计划项目(2021KY1178); 金华市科技计划项目(2023-4-085)
作者简介: 杨丽雅,本科,副主任护师,主要从事糖尿病患者管理工作,E-mail:ylyjjy_1035@126.com
引用本文:   
杨丽雅, 杜厉英, 张亚当, 姜灵芝. 2型糖尿病患者西格列汀联合二甲双胍与门冬胰岛素联合二甲双胍干预效果比较[J]. 预防医学, 2025, 37(10): 1054-1058.
YANG Liya, DU Liying, ZHANG Yadang, JIANG Lingzhi. Comparison of intervention effects between sitagliptin combined with metformin and insulin aspart combined with metformin among patients with type 2 diabetes mellitus. Preventive Medicine, 2025, 37(10): 1054-1058.
链接本文:  
http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2025.10.016      或      http://www.zjyfyxzz.com/CN/Y2025/V37/I10/1054
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