利拉鲁肽治疗新诊断2型糖尿病的疗效分析

Clinical effect of liraglutide intreatment of patients with newly-diagnosed type 2 diabetes mellitus

目的以复合终点达标率为评价指标,比较利拉鲁肽与预混胰岛素治疗新诊断2型糖尿病患者的短期疗效。方法选取2012年1月-2013年5月该院新诊断2型糖尿病患者80例,按随机数字表随机分为利拉鲁肽组(n=40)和预混胰岛素组(n=40),分别给予利拉鲁肽和预混胰岛素治疗,疗程12周。分别于0周及12周测收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(Hb A1c),计算体重指数(BMI),记录低血糖发生情况。以Hb A1c<7.0%、血压<130/80 mm Hg、TG<1.7 mmol/L、LDL-C<2.6 mmol/L、BMI<24 kg/m2,以及没有发生低血糖事件构建复合终点达标标准。结果治疗前两组各项指标比较差异均无统计学意义(P>0.05);治疗后两组BMI、FPG、2 h PBG、Hb A1c均显著下降(P<0.01),利拉鲁肽组TC亦显著下降(P<0.05)。两组SBP、DBP、TG、LDL-C及预混胰岛素组TC的差异均无统计学意义(P>0.05);两组间BMI、SBP、DBP、TG、TC、LDL-c、FPG、2 h PBG、Hb A1c差异均无统计学意义(P>0.05)。利拉鲁肽组低血糖发生率为2.6%,显著低于预混胰岛素组(P<0.05),复合终点达标率为41%,显著高于预混胰岛素组(P<0.05)。结论以复合终点达标率为评价指标,利拉鲁肽治疗新诊断2型糖尿病患者的短期疗效显著优于预混胰岛素。

[Objective] To compare the effects of liraglutide and premixed insulin on rate of achieving composite outcome in patients with newly-diagnosed type 2 diabetes mellitus. [Methods] Materials from 80 patients with newly-diagnosed type 2 diabetes mellitus were collected and all the patients were randomly divided into liraglutide group （n =40） and premixed insulin group （n =40）. Liraglutide was administrated in liraglutide group for 12 weeks while premixed insulin in premixed insulin group. Systolic blood pressure, diastolic blood pressure, triglyceride, total cholesterol, low density lipoprotein cholesterin, fasting plasma glucose, 2-hour postprandial blood glucose, Hemoglobin A1C were measured, while body mass index was calculated and the incidence of hypoglycemia was inquired at the 0, 12 week. The composite outcome was constructed by HbAle 〈 7.0%, blood pressure 〈 130/80 mmHg, TG 〈 1.7 retool/L, LDL-C 〈 2.6 mmol/L, BMI 〈 24 kg/m2 and without the incidence of hypoglycemia. [Results] There were not significant difference in body mass index, systolic blood pressure, diastolic blood pressure, triglyceride, total cholesterol, low density lipoprotein cholesterin, fasting plasma glucose, 2-hour postprandial blood glucose, Hemoglobin A1C between two groups at 0 week （P〉0.05）. At 12 week, body mass index, fasting plasma glucose, 2-hour postprandial blood glucose, Hemoglobin A1C in two groups were significantly reduced （P〈0.01） and total cholesterol in liraglutide group was also significantly reduced （P 〈0.05）, while systolic blood pressure, diastolic blood pressure, triglyceride, low density lipoprotein cholesterin in two groups and total cholesterol in premixed insulin group were not reduced significantly （P〉0.05）. However there were not significant difference in body mass index, systolic blood pressure, diastolic blood pressure, triglyceride, total cholesterol, low density lipoprotein cholesterin, fasting plasma glucose, 2-hour postprandial blood glucose, Hemoglobin A1C between two groups （P〉0.05）. The incidence rate of hypoglycemia in liraglutide group was 2.6% and significantly lower than premixed insulin group （P〈0.01）, while the rate of achieving composite outcome was 41% and significantly better than premixed insulin group （P 〈0.05）. [ Conclusion] The effect of liraglutide on the composite outcome in patients with newly-diagnosed T2DM was better than premixed insulin.