利拉鲁肽、格列美脲分别联用二甲双胍治疗肥胖型2型糖尿病疗效观察

Efficacy of lilarutide and glimepiride combined with metformin respectively in treatment of obese type 2 diabetes mellitus

目的:探究利拉鲁肽、格列美脲分别联用二甲双胍治疗肥胖型2型糖尿病的疗效。方法:选择120例肥胖型2型糖尿病患者,根据随机数字表法分为对照组(格列美脲联用二甲双胍)和试验组(利拉鲁肽联用二甲双胍),每组60例。比较两组患者治疗前后胰岛细胞功能指标[胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能指数(HOMA-β)]、生化指标[血清淀粉样蛋白A(SAA)、空腹血糖(FPG)、餐后2 h血糖(2hPG)和糖化血红蛋白(HbA1c)]以及心功能指标[6 min步行试验(6MWT)、左心室射血分数(LVEF)和N末端B型利钠肽原(NT-proBNP)]。结果:治疗前,两组患者上述指标比较均无统计学差异(均P>0.05)。治疗后,两组患者HOMA-IR低于治疗前,HOMA-β高于治疗前,且试验组HOMA-IR低于对照组,HOMA-β高于对照组(均P<0.05);两组患者SAA、FPG、2hPG、HbA1c均低于治疗前,且试验组SAA、FPG、2hPG、HbA1c均低于对照组(均P<0.05);两组患者6MWT与LVEF均高于治疗前,NT-proBNP均低于治疗前,且试验组6MWT与LVEF均高于对照组,NT-proBNP低于对照组(均P<0.05)。结论:相比于格列美脲联合二甲双胍方案,利拉鲁肽联合二甲双胍治疗肥胖型2型糖尿病效果更佳,心功能改善也相对较好。

Objective:To investigate the efficacy of lilarutide and glimepiride combined with metformin respectively in the treatment of obese type 2 diabetes mellitus.Methods:120 obese patients with type 2 diabetes were selected and divided into control group(glimepiride combined with metformin)and experimental group(lilarutide combined with metformin)according to the random number table method,with 60 cases in each group.The islet cell function indexes[insulin resistance index(HOMA-IR)and isletβcell function index(HOMA-β)],biochemical indexes[serum amyloid A(SAA),fasting blood glucose(FPG),2 hours postprandial blood glucose(2hPG)and glycosylated hemoglobin(HbA1c)]and cardiac function indexes[6 minutes walk test(6MWT),left ventricular ejection fraction(LVEF)and N-terminal pro-B-type natriuretic peptide(NT-proBNP)]were compared between the two groups.Results:Before treatment,there was no statistical difference in the above indicators between the two groups(all P>0.05).After treatment,HOMA-IR of the two groups was lower than that before treatment,and HOMA-βwas higher than that before treatment,and HOMA-IR of the experimental group was lower than that of the control group,and HOMA-βwas higher than that of the control group(all P<0.05);FPG,2hPG,HbA1c were lower than those before treatment,and SAA,FPG,2hPG,HbAlc in the experimental group were lower than those in the control group(all P<0.05);6MWT and LVEF of the two groups were higher than those before treatment,and NT-proBNP was lower than that before treatment,and 6MWT and LVEF of the experimental group were higher than those of the control group,and NT-proBNP was lower than that of the control group(all P<0.05).Conclusion:Compared with the regimen of glimepiride combined with metformin,lilarutide combined with metformin is more effective in the treatment of obese type 2 diabetes,and the improvement of heart function is relatively better.