二甲双胍联合艾塞那肽治疗2型糖尿病合并肥胖病患者的临床疗效

Clinical Efficacy of Metformin Combined with Exenatide on Patients with Type 2 Diabetes Complicated with Obesity

目的观察二甲双胍联合艾塞那肽治疗2型糖尿病合并肥胖病患者的临床疗效。方法选取2014年1月至2015年1月武汉市普仁医院收治的2型糖尿病合并肥胖患者66例,按照随机数字表法分为观察组和对照组,各33例。对照组采用二甲双胍进行治疗(500 mg/次,每日3次),观察组患者在此基础上给予艾塞那肽(5μg/次,1次/d)进行治疗。比较两组患者治疗前后的临床指标、血压、血糖、血脂情况变化。结果治疗后,观察组患者的臀围、腰围、体内脂肪比、体质指数、空腹血糖、餐后2 h血糖、低密度脂蛋白胆固醇、总胆固醇、三酰甘油显著低于对照组[(93±5)cm比(95±6)cm,(80±4)cm比(84±5)cm,(23±3)%比(25±4)%,(23±2)kg/m2比(25±3)kg/m2,(8.3±1.3)mmol/L比(10.3±1.9)mmol/L,(9.0±2.3)mmol/L比(11.5±2.9)mmol/L,(2.45±0.24)mmol/L比(3.02±0.37)mmol/L,(4.7±0.5)mmol/L比(6.03±1.11)mmol/L,(2.4±0.4)mmol/L比(3.2±0.9)mmol/L],高密度脂蛋白胆固醇高于对照组[(1.62±0.42)mmol/L比(1.23±0.21)mmol/L],差异有统计学意义(P<0.05)。两组患者的不良反应发生率差异无统计学意义(P>0.05)。结论二甲双胍联合艾塞那肽治疗2型糖尿病合并肥胖病患者,能明显降低患者的血糖、血脂水平,安全性高,临床疗效良好。

Objective To study the clinical efficacy of metformin combined with exenatide on patients with type 2 diabetes complicated with obesity. Methods Total of 66 patients with type 2 diabetes complicated with obesity in Wuhan Puren Hospital from Jan. 2014 to Jan. 2015 were included in the study,according to a random number table they were divided into an observation group and a control group, 33 cases in each group. The control group was treated with metformin （500 mg/time, 3 times/day）, the observation group was added exenatide （ 5 μg/time, 1 time/day） for treatment on the basis of the control group. The clinical parameters, blood pressure, blood sugar, blood lipid changes of the two groups before and after treatment were compared. Results After treatment, the hip circumference, waist circumference, body fat ratio, body mass index, fasting plasma glucose, postprandial 2 h plasma glucose,low-density lipopretein, total cholesterol, triglycerides of the observation group were significantly lower than the control group [ （ 93 ± 5 ） cm vs （95 ± 6 ） cm, （ 80±4） cmvs （84±5） cm,（23±3）% vs （25±4） %,（23±2） kg/m2 vs （25 ±3） kg/m^2,（8.3±1.3） mmol/L vs （10.3±1.9） mmol/L, （9.0 ±2.3） mmol/L vs （11.5±2.9） mmol/L, （2.45 ± 0. 24） mmol/L vs （ 3.02±0. 37 ） mmol/L, （4. 7± 0. 5 ） mmol/L vs （ 6.03 ± 1.11 ） mmol/L, （ 2.4±0. 4） mmol/L vs （3.2±0.9） mmol/L], the high-density lipopretein was higher than the control group [ （ 1.62 ±0. 42 ） mmol/L vs （ 1.23 ± 0.21 ） mmol/L ], the differences were statistically significant （ P 〈 0. 05 ）. Adverse reaction rates of the two groups were not significantly different（ P 〉 0. 05 ）. Conclusion Mefformin combined with exenatide treatment of patients with type 2 diabetes complicated with obesity, can significantly lower blood sugar, blood lioid levels, with good safety and clinical efficacy.