利拉鲁肽注射液联合胰岛素治疗老年肥胖糖尿病的短期疗效及安全性

Short-term efficacy and safety of liraglutideinjection combined withinsulin inobese diabetes mellitus

目的 探讨利拉鲁肽注射液注射液联合胰岛素泵皮下输注胰岛素治疗初发肥胖糖尿病的短期治疗效果。方法 选取2015年5月~2016年8月桐乡市卫生学校附属康复医院、桐乡市第四人民医院和桐乡市乌镇卫生院内分泌专科门诊收治的100例糖尿病患者的临床资料,按照随机分配方法将患者随机分为3组,即胰岛素＋利拉鲁肽注射液1.2 mg/d组（治疗1组）、胰岛素＋二甲双胍0.5 tid组（治疗2组）及胰岛素强化组（对照组）,对照组20例,其余每组均40例。每组患者采用各自的治疗方案进行治疗。目标血糖为：空腹血糖≤7.0 mmol/L,餐后2 h血糖≤10 mmol/L即认为达标,血糖≤4.4 mmol/L认为偏低,血糖≤3.9 mmol/L认为低血糖。2组患者均坚持3个月的治疗,于入院时、治疗2周后和治疗6个月抽取静脉血进行生化检查。比较相应的生化指标、2种治疗方案的治疗效果。结果 在治疗2周后和治疗3个月后,3组患者在空腹胰高血糖素水平、空腹C肽和体重指数之间比较差异均有统计学意义（P〈0.05）;3组患者的用胰岛素总量、达标时间和低血糖发生次数之间比较,差异均有统计学意义（P〈0.05）。结论采用3种治疗方案治疗老年肥胖糖尿病均具有显著的疗效,但胰岛素＋利拉鲁肽注射液1.2 mg/d的治疗方案在糖尿病的各项生化指标的控制和患者的胰岛素使用总量、血糖达标时间以及发生低血糖的次数方面,均优于其他2组的治疗方案。

Objective To investigate the short-term therapeutic effect of liraglutide injection combined with insulin pump subcutaneous infusion of insulin in the treatment of early-onset obesity. Methods 100 patients with diabetes mellitus treated with endocrine specialist outpatients from May 2015 to August 2016 in our hospital were selected and randomly divided into three groups, insulin ＋ liraglutide injection 1. 2 mg/d group （treatment group 1）, insulin ＋ metformin 0. 5 tid group （treatment group 2 ） and insulin intensive group （ control group）. The control group of 20 cases, the remaining 40 cases each group. Each patient was treated with their own treatment regimen. Target blood glucose ： fasting blood glucose 矣 7. 0 mmol/L,2 h postprandial blood glucose^10 mmol/L that is compliance, blood glucose ^4. 4 mmol/L that low, blood glucose ^3. 9 mmoi/L that low blood sugar. Two groups of patients adhere to three months of treatment. At the time of admission, after 2 weeks of treatment and 6 months of treatment, venous blood was taken for biochemical examination. The corresponding biochemical indicators were compared and the therapeutic effects of the two regimens were compared. Results There were significant differences in the levels of fasting glucagon, fasting C-peptide and body mass index between the two groups after three weeks of treatment and three months after treatment （ P 〈 0. 05 ）. The total amount of insulin, the time of reaching the standard and the frequency of hypoglycemia of three groups were compared, the difference was statistically significant （ P 〈 0. 05 ）. Conclusion Using three kinds of treatment for the treatment of elderly obese diabetesmellitus have a significant effect. However, the treatment regimen of insulin ＋ liraglutideinjection 1. 2 mg/d is effective in the control of diabetes and the total insulin dosage, as well as the number of hypoglycemia occurred, are better than the other two groups of treatment.