摘要
目的对二肽基肽酶Ⅳ（DPP-4）抑制剂治疗2型糖尿病的有效性及安全性进行评价。方法计算机检索Cochrane图书馆、PubMed、EMBASE、ScienceCitationIndex、中国期刊全文数据库、中文科技期刊数据库、中国生物医学文献数据库、万方医学数据库，检索时间截至2013年8月。英文检索词包括sitagliptin、vildagliptin、saxagliptin、linagliptin、alogliptin、dipeptidyl-peptidase1V、systematicreviews和meta-analysis，中文检索词包括西格列汀、维格列汀、沙格列汀、利格列汀、阿格列汀、二肽基肽酶Ⅳ抑制剂、系统评价和meta分析。根据纳入和排除标准，提取符合标准的系统评价／meta分析，用OQAQ量表评价其方法学质量并赋分（1-7分，分数高者质量好），用描述性分析的方法分析资料，主要结局指标包括糖尿病患者糖化血红蛋白（HbAlc）、稳态模型的p细胞功能指数（HOMA-B）和不良事件发生率。结果共纳入18个系统评ffF／meta分析，方法学质量评分为6．0～7．0者16个占89％。18篇文献中13篇评价了DPP-4抑制剂对2型糖尿病患者HbAlc水平的影响，西格列汀、维格列汀、沙格列汀和利拉列汀在降低HbAlc水平方面与其他口服降糖药相似，沙格列汀与西格列汀降低HbAlc疗效相似。5篇文献评价了DPP-4抑制剂对2型糖尿病患者HOMA·母的影响。与安慰剂相比，西格列汀、维格列汀、沙格列汀能有效改善2型糖尿病患者的HOMA—p水平；西格列汀改善2型糖尿病患者HOMA．B水平的疗效不优于其他口服降糖药。14篇文献评价了DPP-4抑制剂治疗过程中的不良事件发生率，应用西格列汀、维格列汀、沙格列汀和利拉列汀治疗的患者不良事件发生率和低血糖发生率与应用安慰剂的患者比较差异无统计学意义；西格列汀和维格列汀诱发低血糖的概率低于其他口服降糖药。结论DPP-4抑制剂能有效控制2型糖尿病患者的血糖，短期安全性较好。
Objective To evaluate the efficacy and safety of dipeptidyl-peptidase 1V （DPP-4） inhibitors for treatment of type 2 diabetes mellitus. Methods The Cochrane Library, PubMed, Embase, Science Citation Index, the Chinese Journal Full-text Database, Chinese Scientific and Technical Periodicals Database, Chinese Biomedical Literature Database, and Wanfang Database were searched from the inception to August 2013. The key words were sitagliptin, vildagliptin, saxagliptin, linagliptin, alogliptin, dipeptidyl- peptidase IV, systematic reviews, and meta-analysis. According to the inclusion and exclusion criteria, articles for systematic reviews and meta-analysis were selected. Their methodological qualities were evaluated using QQAQ scale and the data were analyzed using descriptive analysis. The main outcomes included the changes in hemoglobin Alc （HbAlc） and homeostasis model assessment of 13-cell index （HOMA-13） and incidence of adverse events. Results A total of 18 articles were entered in this study. Of them, scores of methodological quality in 89 percent of articles （16 articles） were 6.0-7.0. The effects of DPP-4 inhibitors on HbAlc levels in patients with type 2 diabetes mellitus were evaluated in thirteen articles. The effects of sitagliptin, vildagliptin, saxagliptin, and linagliptin on HbAlc reduction were better than those of the placeboes, but the conclusions were controversial with other oral hypoglycemie drugs. The effects of DPP-4 inhibitors on HOMA-13 levels in patients with type 2 diabetes mellitus were evaluated in five articles.Sitagliptin, vildagliptin, and saxagliptin could significantly improve HOMA-13 levels compared with the placeboes. The effect of sitagliptin on HOMA-~ level improvement was not better than other oral antidiabetic drugs. The incidences of adverse events during the DPP-d treatments were evaluated in 14 articles. The differences in the incidences of adverse events and hypoglycemia between the treatments with sitagliptin, vildagliptin, saxagliptin, linagliptin and the placeboes were not statistically significant. The incidences of hypoglycemia in treatment with sitagliptin and vidagliptin were lower than those with other oral hypoglycemic drugs. Conclusion DPP-4 inhibitors could control effectively the blood glucose in patients with type 2 diabetes mellitus and the short-term safety was good.
出处
《药物不良反应杂志》
CSCD
2013年第6期314-319,共6页
Adverse Drug Reactions Journal
关键词
二肽基肽酶Ⅳ抑制剂
2型糖尿病
META分析
系统评价
Dipeptidyl-peptidase 1V inhibitors
Type 2 diabetes mellitus
Meta-analysis
Systematic review
