文献类型：期刊文献

中文题名：二甲双胍联合埃索美拉唑对老年2型糖尿病患者血清胃泌素和血糖的影响

英文题名：Effect of combined Metformin and Esomeprazole therapy on plasma gastrin and blood glucose in elderly patients with type 2 diabetes mellitus

作者：刘世雄[1];赵丽[2];周芸[1];王晶[1];严祥[1]

第一作者：刘世雄

机构：[1]兰州大学第一医院老年科,兰州730000;[2]甘肃中医药大学附属医院超声科,兰州730020

第一机构：兰州大学第一医院老年科,兰州730000

年份：2016

卷号：35

期号：4

起止页码：405

中文期刊名：中华老年医学杂志

外文期刊名：Chinese Journal of Geriatrics

收录：CSTPCD;;北大核心:【北大核心2014】；CSCD:【CSCD_E2015_2016】；

基金：甘肃省自然科学基金（1308RJZA219）;甘肃省胃肠病重点实验室开放课题基金项目（gswcky-2012-004）

语种：中文

中文关键词：糖尿病,2型;质子泵抑制剂;二甲双胍;胃泌素类;血糖

外文关键词：Diabetes mellitus, type 2 ; Proton pump inhibitor; Metformin; Gastrins;Blood glucose

摘要：目的观察二甲双胍联合埃索美拉唑对老年2型糖尿病患者血清胃泌素和血糖、糖化血红蛋白（HbAlc）、胰岛素等的影响。方法采用随机、对照、双盲研究方法，将41例老年2型糖尿病患者随机分为治疗组和对照组，治疗组在口服二甲双胍（0．5g，2～3次／d）治疗的基础上加用埃索美拉唑镁肠溶片口服（20mg，1次／d），对照组在口服二甲双胍（0．5g，2～3次／d）治疗的基础上加用埃索美拉唑镁模拟片，疗程均为12周。分别采集治疗前后空腹静脉血，比较空腹血清胃泌素、血糖、HbAlc、胰岛素以及血脂、肝。肾功能等，计算胰岛素抵抗指数（HOMA-β）、胰岛素分泌指数（HOMA—IR），并记录不良反应。结果治疗组和对照组治疗前后以及两组间的体质量、腰围、体质指数比较，差异均无统计学意义；治疗12周后，治疗组血清胃泌素浓度较治疗前增加[（127．20±9．21）ng／L比（131．53±7．84）ng／L]，但差异无统计学意义（P〉0．05）；而对照组则无明显变化[（128．42±4．58）ng／L比（127．51±3．47）ng／L，P〉0．05]。治疗前后两组血糖、HbAlc、胰岛素、HOMA—β、HOMA—IR均无明显变化，差异均无统计学意义（均P〉0．05）。结论老年2型糖尿病患者二甲双胍联合埃索美拉唑治疗后，血清胃泌素和胰岛素未见明显升高，对血糖、HbAlc亦无明显降低作用。
Objective To investigate the effect of combined Metformin and esomeprazole therapy on plasma levels of gastrin, blood glucose, glycosylated hemoglobin（HbAlc） and insulin in elderly patients with type 2 diabetes. Methods A randomized,double-blind,placebo-controlled study of 41 elderly patients with type 2 diabetes was conducted. Patients were randomly assigned into treatment group（combination therapy with Metformin 0.5 g, bid or tid and Esomeprazole 20 mg, qd, for 12 weeks）and placebo group（Metformin monotherapy 0.5 g, bid or tid, for 12 weeks）. Fasting blood samples were taken from vein before and after treatment. Fasting serum levels of gastrin, glucose, HbAlc, insulin, lipids, liver and renal functions were compared between the two groups. The homeostasis model of assessment for insulin resistance index（ HOMA-IR） and insulin secretion index （HOMA-13）were calculated, and complications were recorded. Results There were no significant differences in body mass index and waist circumference between the two groups. Serum gastrin level was slightly increased in the treatment group 12 weeks after treatment, but without statistically significance [（127.20±9.21）ng/L vs. （131.53±7.84）ng/L,P〉0.05] ,and serum gastrin level had no significant differences in the placebo group before and after treatment [（ 128.42 ± 4.58） ng/L vs. （127.51±3.47） ng/L, P〉0.05}. However, there were no significant differences in the changes of blood glucose, HbAlc,insulin, HOMA-β and HOMA-IR before versus after therapy, and between the two group（all P〉0.05）. Conclusions Combined Metformin and insulin therapy cannot increase serum gastrin and insulin levels and has no significant effect on reducing blood glucose and HbAlc levels in elderly patients with type 2 diabetes.