目的 研究达格列净联合西格列汀治疗脆性2型糖尿病患者的临床疗效。方法 将2017年7月—2019年7月延安大学附属医院收治的80例脆性2型糖尿病患者作为研究对象，将患者随机分为对照组和观察组，每组各40例。对照组口服磷酸西格列汀片治疗，100 mg/d。观察组在对照组基础上口服达格列净片，10 mg/d。两组疗程为12周。比较两组治疗前后的空腹血糖（FBG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbAlc）、日间血糖平均绝对差（MODD）、餐后血糖波动幅度（PPGE）、白细胞介素-4（IL-4）、白细胞介素-6（IL-6）、肿瘤细胞坏死因子（TNF）-α水平。结果 治疗后，两组患者FBG、2 h PG、HbA1c均显著降低（P<0.05），且观察组FBG、2 h PG、HbA1c显著低于对照组（P<0.05）。治疗后，两组患者MODD和PPGE均显著低于治疗前（P<0.05），且观察组MODD和PPGE明显低于对照组（P<0.05）。治疗后，两组患者IL-4、IL-6、TNF-α水平均显著降低（P<0.05），且观察组炎性因子水平显著低于对照组（P<0.05）。结论 达格列净联合西格列汀能起到协同作用，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，减少血糖波动与低血糖的风险。

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