利拉鲁肽治疗2型糖尿病的疗效

Clinical Effect of Liraglutide on Type 2Diabetes Mellitus

目的观察利拉鲁肽治疗2型糖尿病(T2DM)患者的疗效及不良反应。方法将75例确诊为T2DM的患者按随机数字表法分为利拉鲁肽组(38例)和格列美脲组(37例)。利拉鲁肽组给予利拉鲁肽1.8mg·d-1皮下注射,格列美脲组给予格列美脲4 mg·d-1口服。2组均16周为1个疗程。观察2组治疗前后的糖化血红蛋白(HbA1c)、血糖、体质量、收缩压、β细胞功能指数(HOMA-β)的变化及不良反应(恶心、腹泻、低血糖)发生率。结果治疗后2组FPG、2hPG、HbA1c均较治疗前明显下降(均P<0.05),但2组间比较差异无统计学意义(P>0.05)。治疗后2组HOMA-β较治疗前明显升高,利拉鲁肽组较格列美脲组升高更明显(均P<0.05)。利拉鲁肽组的体质量减轻、收缩压降低与格列美脲组比较差异均有统计学意义(均P<0.05)。利拉鲁肽组早期胃肠道反应(恶心、腹泻)明显高于格列美脲组(P<0.05),格列美脲组低血糖事件发生率明显高于利拉鲁肽组(16.2%比0.00%,P<0.05)。结论利拉鲁肽治疗T2DM安全、有效。

ABSTRACT:Objective To observe the curative and adverse effects of liraglutide on type 2 diabe-tes mellitus(T2DM).Methods Seventy-five patients with T2DM were randomly assigned to receive either subcutaneous liraglutide injection(1.8 mg·d-1 ,38 patients)or oral glimepiride(4 mg·d-1 ,37 patients)for 16 weeks.The glycosylated hemoglobin(HbA1c),blood glucose,body weight,sys-tolic blood pressure(SBP),homeostasis model assessment ofβ-cell function(HOMA-β)and inci-dence of adverse events(nausea,diarrhea and hypoglycemia)were observed before and after treat-ment.Results The levels of fasting plasma glucose,2-hour postprandial blood glucose and HbA1c significantly decreased after treatment in both groups(P <0.05).However,no significant differences in these three indicators were found between the two groups(P >0.05).The HOMA-β index significantly increased after treatment in both groups (P < 0.05 ).Compared with glimepiride group,HOMA-βindex and early gastrointestinal reactions(nausea and diarrhea)sig-nificantly increased and body weight and SBP significantly decreased in liraglutide group(P <0.05).In addition,the incidence of hypoglycemia in glimepiride group was significantly higher than that in liraglutide group(16.2% vs 0.00%,P <0.05).Conclusion Liraglutide injection is safe and effective for T2DM.