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目的观察胰岛素促泌剂及阿卡波糖对血浆胰升血糖素样肽-1(GLP-1)、胰升血糖素(GC)的影响。方法选取新诊断T2DM患者127例,随机分为格列本脲(GG)组34例、瑞格列奈(RG)组32例、阿卡波糖(AG)组31例及西格列汀(SG)组30例。治疗12周,观察各组血糖、HbA_1c、GLP-1及GC的变化。结果各组治疗后FPG、2 hPG、HbA_1c均降低,GG组和RG组△HbA_1c高于AG组和SG组(P<0.05);AG组和SG组治疗后FGLP-1、2 hGLP-1升高,FGC、2 hGC降低(P<0.05);GG组和RG组治疗后空腹GLP-1(FGLP-1)、2 hGLP-1、空腹GC(FGC)及2 hGC与治疗前比较,差异无统计学意义(P>0.05);SG组ΔFGLP-1、2 hGLP-1及ΔFGC均高于AG组(P<0.05)。结论格列本脲和瑞格列奈降糖效果优于西格列汀和阿卡波糖。西格列汀与阿卡波糖均能升高血浆GLP-1,降低GC水平。格列本脲和瑞格列奈无调节GLP-1和GC的作用。
Objective To observe the effect of insulin secretagogues and acarbose on plasma glucagon-like peptide-1 (GLP-1) and glucagon (GC). Methods A total of 127 newly diagnosed T2DM patients were randomly divided into GG group (n = 34), repigliadin group (n = 32), acarbose group (31) and sitagliptin SG) group of 30 cases. After 12 weeks of treatment, the changes of blood glucose, HbA 1c, GLP-1 and GC were observed. Results After treatment, the levels of FPG, 2 hPG and HbA_1c in each group were decreased, while △ HbA_1c in GG group and RG group were higher than those in AG group and SG group (P <0.05) (P <0.05). The levels of fasting plasma GLP-1 (FGLP-1), fasting plasma GC (FGC) and 2 hGC in GG group and RG group after treatment were lower than those before treatment Statistical significance (P> 0.05). The levels of ΔFGLP-1, hGLP-1 and ΔFGC in SG group were higher than those in AG group (P <0.05). Conclusion Glibenclamide and repaglinide have better hypoglycemic effect than sitagliptin and acarbose. Both sitagliptin and acarbose increased plasma GLP-1 and decreased GC levels. Glibenclamide and repaglinide did not modulate the effects of GLP-1 and GC.