胰岛素联合利拉鲁肽治疗糖尿病并发冠心病的临床疗效及其安全性

Clinical efficacy and safety of insulin combined with liraglutide in the treatment of diabetes mellitus complicated with coronary heart disease

目的探讨胰岛素联合利拉鲁肽治疗糖尿病并发冠心病的临床疗效及其安全性。方法选取2019年1月—2020年1月长沙市雨花区洞井街道社区卫生服务中心收治的糖尿病并发冠心病患者120例,采用摸球法分组分为对照组和研究组,各60例。对照组采用胰岛素治疗,研究组采用胰岛素联合利拉鲁肽治疗。比较2组治疗前后空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-β)、体质指数(BMI),血清超敏C反应蛋白(hs-CRP)、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平,并观察2组治疗期间不良反应发生情况。结果治疗前2组FPG、2 hPG、HbA1c比较,差异无统计学意义(P>0.05);治疗后研究组FPG、2 hPG、HbA1c低于对照组(P<0.05)。治疗前2组HOMA-IR、HOMA-β、BMI比较,差异无统计学意义(P>0.05);治疗后研究组HOMA-IR、BMI低于对照组,HOMA-β高于对照组(P<0.05)。治疗前2组血清hs-CRP、IL-6、TNF-α水平比较,差异无统计学意义(P>0.05);治疗后研究组血清hs-CRP、IL-6、TNF-α水平低于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论胰岛素联合利拉鲁肽治疗糖尿病并发冠心病的临床疗效确切,可改善血糖、胰岛素控制效果,减轻体质量、炎性反应,且安全性较高。

Objective To investigate the clinical efficacy and safety of insulin combined with liraglutide in the treatment of diabetes mellitus complicated with coronary heart disease.Methods A total of 120 cases of patients with diabetes mellitus were selected from January 2019 to January 2020 in Changsha Yuhua District Dongjing Street Community Health Service Center,which were divided into control group and study group by ball touching method,with 60 cases in each group.The control group was treated with insulin,and the study group was treated with insulin combined with liraglutide.Fasting blood glucose(FPG)and 2 h postprandial blood glucose(2 hPG),HbA1 c,HOMA-IR,HOMA-β,BMI,serum hs-CRP,IL-6,TNF-αlevels before and after treatment,and the incidence of adverse reactions in the two groups were observed.Results Before treatment,there was no significant difference in FPG,2 hPG and HbA1 c between the two groups(P>0.05);after treatment,FPG,2 hPG and HbA1 c in the study group were lower than those in the control group(P<0.05).Before treatment,there was no significant difference in HOMA-IR,HOMA-βand BMI between the two groups(P>0.05);after treatment,HOMAIR and BMI in the study group were lower than those in the control group,and HOMA-βwas higher than those in the control group(P<0.05).Before treatment,there was no significant difference in the levels of hs-CRP,IL-6 and CRP between the two groups(P>0.05);after treatment,the levels of hs-CRP,IL-6 and CRP in the study group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Insulin combined with liraglutide has definite clinical effect on diabetes mellitus complicated with coronary heart disease.It can improve the control effect of blood glucose and insulin,reduce body weight and inflammatory reaction,and with high safety.