利拉鲁肽注射液对肥胖2型糖尿病患者血脂及颈动脉斑块影响的临床研究

Clinical Study of Liraglutide on Blood Lipids and Carotid Plaque in Type 2 Diabetes Mellitus with Obesity

目的:观察利拉鲁肽注射液对肥胖2型糖尿病患者血脂及颈动脉斑块的影响。方法:将100例2型糖尿病合并肥胖、颈动脉斑块的患者随机分为对照组及观察组。对照组予以二甲双胍片、阿司匹林肠溶片及阿托伐他汀钙片治疗;观察组予以利拉鲁肽注射液、二甲双胍片、阿司匹林肠溶片及阿托伐他汀钙片治疗。有高血压的患者予以降压治疗,有阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)的患者予以无创气道正压通气(noninvasive positive pressure ventilation,NPPV)治疗。比较治疗前及治疗12周、24周对照组及观察组的血糖、血压、糖化血红蛋白(hemoglobin A_(1c),Hb A_(1c))、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、体质指数(body mass index,BMI)、睡眠呼吸暂停低通气指数(apnea hypopnea index,AHI)、最低血氧饱和度(lowest pulse oxygen saturation,LSpO_2)的变化。彩色多普勒检测患者治疗前及治疗后24周颈动脉内中膜厚度(intima-media thickness,IMT)及颈动脉斑块的面积。结果:对照组及观察组治疗后C肽、LSpO_2较治疗前上升;血糖、HbA_(1c)、TC、LDL-C、BMI、血压、AHI、颈动脉IMT、颈动脉斑块面积都较治疗前显著下降,但观察组比对照组C肽、LSpO_2上升更明显,TC、LDL-C、BMI、IMT、AHI、颈动脉斑块面积下降更明显,且差异具有统计学意义(P<0.05)。结论:使用利拉鲁肽注射液可改善肥胖2型糖尿病合并OSAHS患者的LSpO_2、AHI,降低肥胖2型糖尿病患者的TC、LDL-C,减轻BMI,减少颈动脉IMT及颈动脉斑块的面积。

Objective：To investigate the effects of liraglutide on blood lipids and carotid plaque in type 2 diabetes mellitus with obesity.Methods：100 obese diabetic patients with carotid plaque were randomly divided into an observation group and a control group.Metformin,aspirin and atorvastatin were given in control group,metformin,liraglutide,aspirin and atorvastatin were given in the observation group.Have high blood pressure patients to control blood pressure,OSAHS patients with noninvasive positive pressure ventilation therapy.The blood glucose,blood pressure,HbA1c,blood lipid,BMI,AHI,and LSpO2 of two groups were determined after 12 weeks and 24 weeks of treatment,respectively.Carotid artery intima-media thickness and plaque before treatment and after 24 weeks of treatment were calculated by neck vascular ultrasound.Results：HbA1c,TC,LDL-C,BMI,IMT and carotid artery plaque were decreased significantly in the two groups after treatment,BMI,IMT and carotid artery plaque area were decreased more significantly in the observatio group than control group（P〈0.05）.Conclusion：The treatment of liraglutide in type 2 diabetes mellitus with obesity combined OSAHS can improve LSpO2,reduce the AHI,and reduce the obese patients with type 2 diabetes of TC,LDL-C and the BMI,and reduce IMT and plaque area.