本文選題：糖尿病 + 二肽基肽酶-抑制劑　； 參考：《中國臨床藥理學(xué)雜志》2017年21期

【摘要】：目的系統(tǒng)評(píng)價(jià)再評(píng)價(jià)二肽基肽酶-4(DPP-4)抑制劑和胰高糖素樣肽-1(GLP-1)受體激動(dòng)劑的安全性。方法計(jì)算機(jī)檢索Cochrane Library、Pub Med、中國知網(wǎng)(CNKI)、維普數(shù)據(jù)庫(VIP)、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBM)及萬方數(shù)據(jù)庫,并進(jìn)行手工檢索,篩選有關(guān)DPP-4抑制劑和GLP-1受體激動(dòng)劑治療糖尿病安全性的系統(tǒng)評(píng)價(jià),檢索時(shí)間截至2016年10月。用多系統(tǒng)評(píng)價(jià)評(píng)估問卷(AMSTAR)量表評(píng)價(jià)文獻(xiàn)質(zhì)量,用Rev Man5.3軟件進(jìn)行Meta分析。結(jié)果最終納入46篇文獻(xiàn),AMSTAR評(píng)分均為5分以上。結(jié)果顯示,DPP-4抑制劑與安慰劑相比,不增加低血糖、胃腸道、鼻咽炎、頭痛、感染及心血管不良事件風(fēng)險(xiǎn);而與其他降糖藥相比,低血糖發(fā)生率低,同時(shí)心血管不良事件發(fā)生率低。GLP-1受體激動(dòng)劑與安慰劑相比,低血糖和胃腸道不良反應(yīng)發(fā)生率高,不增加鼻咽炎、頭痛及心血管不良事件風(fēng)險(xiǎn),不增加體重;而與其他降糖藥物相比,低血糖發(fā)生率低,胃腸道反應(yīng)發(fā)生率高,同時(shí)降低體重。DPP-4抑制劑和GLP-1受體激動(dòng)劑均不增加胰腺炎風(fēng)險(xiǎn)。結(jié)論 DPP-4抑制劑安全性較高,而GLP-1受體激動(dòng)劑會(huì)增加胃腸道不良反應(yīng)和低血糖風(fēng)險(xiǎn)。
[Abstract]:Objective to evaluate the safety of dipeptidyl peptidase-4 (DPP-4) inhibitor and glucagon-like peptide-1 (GLP-1) receptor agonist. Methods the Cochrane Library Pub Med, CNKI, VIP, CBM and Wanfang databases were searched by computer. The systematic evaluation of the safety of DPP-4 inhibitors and GLP-1 agonists in the treatment of diabetes mellitus was conducted. The search time is up to October 2016. The literature quality was evaluated with the multiple system Evaluation questionnaire (AMSTAR) and Meta-analysis with the software Rev Man5.3. Results the AMSTAR scores of 46 articles were all above 5. The results showed that the DPP-4 inhibitor did not increase the risk of hypoglycemia, gastrointestinal tract, nasopharyngitis, headache, infection and cardiovascular adverse events compared with placebo, but had a lower incidence of hypoglycemia than other hypoglycemic drugs. At the same time, the incidence of cardiovascular adverse events was lower. GLP-1 receptor agonists had higher incidence of hypoglycemia and gastrointestinal adverse reactions than placebo, and did not increase the risk of nasal pharyngitis, headache and cardiovascular adverse events, and did not increase body weight. Compared with other hypoglycemic drugs, the incidence of hypoglycemia was lower and gastrointestinal reaction was higher than that of other hypoglycemic drugs, while the weight loss of .DPP-4 inhibitor and GLP-1 receptor agonist did not increase the risk of pancreatitis. Conclusion DPP-4 inhibitor is safe, while GLP-1 receptor agonist can increase gastrointestinal adverse reaction and hypoglycemia risk.
【作者單位】： 暨南大學(xué)藥學(xué)院;廣州軍區(qū)廣州總醫(yī)院藥劑科;
【基金】：廣州市科技計(jì)劃基金資助項(xiàng)目(201509010012)
【分類號(hào)】：R977.15

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