艾塞那肽和利拉鲁肽治疗2型糖尿病患者的临床研究

Clinical trial of exenatide and liraglutide in the treatment of patients with type 2 diabetes mellitus

目的观察艾塞那肽和利拉鲁肽对进行持续皮下胰岛素输注治疗的新诊断2型糖尿病患者的临床疗效。方法将60例新诊断2型糖尿病患者随机分为对照组、试验组-1和试验组-2,各20例。3组患者均给予持续皮下胰岛素输注治疗,血糖控制达标后对照组给予二甲双胍,起始剂量0.5 g,每日3次;试验组-1给予艾塞那肽,起始每次5μg,每日2次,1周后改为每次10μg,每日2次,皮下注射。试验组-2给予利拉鲁肽,起始每次0.6 mg,每日1次,1周后改为每次1.2 mg,每日1次,皮下注射。所有患者持续治疗3个月。检测3组患者治疗前后血糖、血脂、肾功能及胰岛α、胰岛β细胞功能,观察药物不良反应发生情况。结果治疗后,试验组-1、试验组-2和对照组的胰岛素抵抗指数分别为1.24±0.21,1.34±0.52和1.72±0.30,AUCins 0-10 min分别为(200.22±14.23),(200.18±13.21)和(109.73±14.34)m U·min,胰岛β细胞功能指数分别为128.92±13.49,126.55±14.21和83.14±8.70,AUCGln 0-8 min分别为(305.78±38.19),(299.22±32.02)和(418.05±47.91)mg·min,血清肌酸酐分别为(70.31±9.28),(82.94±10.70)和(85.43±0.85)μmol·L^-1。试验组-1和试验组-2的上述指标分别与对照组比较,差异均有统计学意义(P<0.05)。试验组-1、试验组-2、对照组的药物不良反应发生率分别为25.00%,20.00%和15.00%,差异均无统计学意义(均P>0.05)。结论艾塞那肽和利拉鲁肽对新诊断2型糖尿病患者持续皮下胰岛素输注后的治疗效果显著,对胰岛细胞功能的改善效果优于二甲双胍。

Objective tide in newly diagnosed type 2 diabetic patients treated with continuous subcutaneous insulin infusion(CSII).Methods newly diagnosed type 2 diabetes mellitus were randomly divided into control group,treatment group-1 and treatment group-2,with 20 cases in each group.All three groups were treated with CSII,and after blood sugar was achieved,metformin was given to control group with initial dose of 0.5 g,three times a day.Treatment group-1 was given exenatide 5μg,twice a day,and then 10μg twice a day after 1 week,subcutaneous injection.Treatment group-2 was given liraglutide 0.6 mg,once a day,and then 1.2 mg once a day after 1 week,subcutaneous injection.All patients were treated for 3 months.Blood sugar,blood lipid,renal function and isletαandβcell function were measured before and after treatment,and adverse drug reactions were observed in three groups.Results group-1,treatment group-2 and control group were 1.24±0.21,1.34±0.52,1.72±0.30,the AUins 0-10 min were(200.22±14.23),(200.18±13.21),(109.73±14.34)m U·min,Homeostasis model assessment-βwere128.92±13.49,126.55±14.21,83.14±8.70,AUCGln 0-8 min were(305.78±38.19),(299.22±32.02),(418.05±47.91)mg·min,serum creatinine were(70.31±9.28),(82.94±10.70),(85.43±0.85)μmol·L^-1.There was significant difference between treatment group-1,treatment group-2 and control group(P<0.05).The incidence of adverse drug reactions in treatment group-1,treatment group-2 and control group were 25.00%,20.00%and 15.00%,without significant differences(all P>0.05).Conclusion and liraglutide of CSII in newly diagnosed patients with type 2 diabetes mellitus is effective,and the improvement of islet cell function is better than that of metformin.