GLP-1受体激动剂联合阿卡波糖治疗T2DM临床效果及其影响

目的探究胰高血糖素样肽-1（GLP-1）受体激动剂联合阿卡波糖治疗肥胖2型糖尿病的临床效果及其对糖脂代谢、炎性因子、miR126水平的影响。方法回顾性分析2015年6月至2016年12月间在常规治疗基础上应用阿卡波糖治疗的患者49例（对照组），以及应用阿卡波糖联合GLP-1受体激动剂治疗的患者49例（观察组）的临床资料。结果治疗后，观察组的临床总有效率为91．84％，显著高于对照组的7347％（P〈0．05）；两组患者的空腹血糖、餐后血糖、BMI水平及总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）水平均低于治疗前，且观察组水平显著低于对照组（P〈0．05）；两组患者的高密度脂蛋白胆固醇（HDL-C）水平及miR126水平均高于治疗前，且观察组水平显著高于对照组（P〈0．05）；两组患者的血清肿瘤坏死因子（TNF-α）、白细胞介素-6（IL-6）、单核细胞趋化蛋白-1（MCP-1）表达水平均低于治疗前（P〈001），且观察组表达水平显著低于对照组（P〈0.01）。结论GLP-1受体激动剂联合阿卡波糖可有效调节肥胖T2DM患者的血糖及血脂水平，能显著下调血清炎症因子，促进miR126的表达，并有效提高临床疗效。

Objective To explore the clinical curative effect of GLP-1 agonists combined with acarbose on obese patients with type 2 diabetes （ T2DM ） and the influence of expression levels of lipid metabolism, inflammatory factors and miR126. Methods The clinical data of 49 patients in control group treated with acarbose on the basis of conventional therapy and 49 patients in observation group treated with acarbose combined with GLP-1 receptor agonists from June 2015 to December 2016 were retrospective analyzed. Results After the treatment, the total clinical effective rate of the observation group was 91.84%, significantly higher than that of control group with 73.47% （P〈0.05） . After the treatment, the levels of fasting plasma glucose, postprandial glucose, BMI level and total cholesterol （TC） , triglyceride （TG） , low density lipoprotein cholesterol （ LDL-C ） in two groups were lower than before, also which in observation group were significantly lower than the control group （ P〈0.05 ） . The levels of high-density lipoprotein cholesterol （ HDL-C ） and miR126 in two groups were higher than before, also which in observation group were significantly higher than the control group （ P〈0.05 ） . The expression levels of the tumor necrosis factor （TNF-a） , interleukin 6 （IL-6） , monocyte chemotactic protein 1 （MCP-1） in serum in the two groups were lower than before, also which in observation group were significantly lower than the control group （P〈0.01） . Conclusion GLP-1 agonists combining with acarbose can effectively balance the level of the blood glucose and lipid, down-regulate the level of serum inflammatory factors, promote expression of miR126 in obese patients with T2DM, and can improve the clinical curative effect.