利拉鲁肽联合二甲双胍对2型糖尿病合并冠心病患者血脂水平、心功能的影响

Influence of liraglutide combined with metformin on blood fat level and heart function in patients with type 2 diabetes mellitus complicated by coronary heart disease

目的探讨利拉鲁肽联合二甲双胍对2型糖尿病合并冠心病患者血脂水平、心功能的影响。方法选择石家庄市第二医院于2016年2月～2017年9月收治的2型糖尿病合并冠心病患者110例,根据随机数字表法将其分为两组,每组各55例。对照组患者二甲双胍片口服治疗,观察组在此基础上给予利拉鲁肽皮下注射治疗。比较两组血糖水平、血脂水平、心功能、生活质量(QOL)、冠状动脉易损斑块发生率及不良反应发生率。结果治疗后,观察组三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)及左室舒张末期内径(LVEDD)水平均较对照组低,高密度脂蛋白胆固醇(HDL-C)、左室射血分数(LVEF)、舒张早期最大峰值速度/舒张晚期最大峰值速度(E/A)水平均较对照组高,差异具有统计学意义(P<0.05);治疗后观察组QOL评分较对照组高(86.65±8.46)分vs.(72.29±8.54)分,差异具有统计学意义(P<0.05);治疗后,观察组冠状动脉易损斑块发生率较对照组低,差异具有统计学意义(P<0.05);两组不良反应发生率相比,差异无统计学意义(P>0.05)。结论利拉鲁肽联合二甲双胍可降低2型糖尿病合并冠心病患者血糖、血脂水平,改善其心功能,提高患者生活质量,且不增加不良反应率,安全性较高。

Objective To investigate the influence of liraglutide combined with metformin on blood fat level and heart function in patients with type 2 diabetes mellitus(T2DM)complicated by coronary heart disease(CHD).Methods The patients with T2DM complicated by CHD(n=110)were chosen from the Second Hospital of Shijiazhuang City from Feb.2016 to Sept.2017,and then divided,according to random digital table,into control group and observation group(each n=55).The control group was orally given metformin tablets and observation group was additionally given hypodermic injection of liraglutide.The levels of blood sugar and blood fat,heart function,quality of life(QOL),and incidence of coronary vulnerable plaques and adverse reactions were compared between 2 groups.Results After treatment,the levels of triglyceride(TG),total cholesterol(TC),lowdensity lipoprotein-cholesterol(LDL-C),glycated hemoglobin(HbAlc),fasting plasma glucose(FPG)and 2-hour postprandial blood glucose(2-hPBG),and left ventricular end-diastolic inner diameter(LVEDd)were lower,and level of high-density lipoprotein-cholesterol(HDL-C),and left ventricular ejection fraction(LVEF)and early diastole inflow velocity/late diastole inflow velocity(E/A)were higher in observation group than those in control group(P<0.05).The scores of QOL were higher in observation group than those in control group[(86.65±8.46)vs.(72.29±8.54),P<0.05]after treatment.The incidence of coronary vulnerable plaques was lower in observation group than that in control group(P<0.05)after treatment.The comparison in incidence of adverse reactions showed that the difference had no statistical significance between 2 groups(P>0.05).Conclusion Liraglutide combined with metformin can reduce levels of blood sugar and blood fat,and improve heart function and QOL,and does not raise incidence of adverse reactions with higher safety.