利拉鲁肽对高血压合并2型糖尿病患者颈动脉内膜中层厚度的影响研究

Analyze the Effects of Liraglutide on Carotid Intima⁃media Thickness in Hypertension Patients with Type 2 Diabetes Mellitus

目的:分析利拉鲁肽对高血压合并2型糖尿病患者颈动脉内膜中层厚度的影响。方法:纳入2019.1-2019.12在中山大学附属第五医院心血管病中心明确诊断高血压合并2型糖尿病患者共70例,根据降糖方案的不同将患者分为GLP⁃1RA组29例,胰岛素组41例,收集所有患者的一般临床资料,实验室检查,颈动脉IMT等指标,分析各组患者治疗前后组内、组间相关临床指标变化情况。结果:两组患者在性别、冠心病病史、吸烟史、收缩压无显著统计学差异;但在年龄、BMI、腰围、臀围、腰臀比、心率、舒张压存在显著统计学差异。两组患者治疗效果组内分析比较:胰岛素组:糖化血红蛋白较治疗前有所改善;颈动脉IMT无改善,较治疗前显著增厚。GLP⁃1RA组:腰围、收缩压、舒张压、糖化血红蛋白、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、颈动脉IMT较治疗前得到显著改善(P均<0.05);此外该组患者治疗后臀围,腰臀比,心率也有所改善。两组患者组间比较:GLP⁃1RA组患者较胰岛素患者在体重、BMI、腰围、腰臀比、心率、空腹血糖、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、颈动脉IMT改善更为显著(P均<0.05)。结论:利拉鲁肽治疗较胰岛素更为显著的改善高血压合并T2DM患者体重、腰围、臀围、心率、血压、糖化血红蛋白、空腹血糖、血脂水平及颈动脉IMT,具有一定的血管保护作用。

Objective:To analyze the effects of liraglutide on carotid intima-media thickness in hypertension patients with type 2 diabetes mellitus.Methods:Clinical data of 70 hypertension patients with type 2 diabetes mellitus admitted during January 2019 to December 2019 were retrospectively analyzed.The patients were divided into GLP-IRA group(n=29) and Insulin group(n=41).Baseline data,laboratory tests,carotid intima media thickness(IMT) were compared between two groups.Results:There were no significant differences in gender,history of coronary heart disease,smoking history or systolic blood pressure in two groups.But there were significant differences in age,weight,BMI,waist circumference,hip circumference,waist-to-hip ratio(WHR),heart rate,and diastolic blood pressure between two groups.HbAlc level,fasting blood glucose after treatment were significantly lower than those before treatment.IMT after treatment were significantly higher than those before treatment in the insulin group.There were significant differences in waist circumference,blood pressure,HbAlc level,TC,TG,LDL-C,IMT after treatment compared with pre-treatment;and the hip circumference,waist-to-hip ratio,heart rate also get improvement in the GLP-IRA group.The weight,BMI,hip circumference,WHR,heart rate,fasting blood glucose,TC,TG,LDL-C,IMT got more significantly improvement in GLP-IRA group than insulin group(P<0.05).Conclusion:Liraglutide can decrease weight,BMI,waist circumference,hip circumference,heart rate,blood pressure,fasting blood glucose,HbAlc level,TC,TG,LDL-C,IMT;liraglutide can improve IMT of hypertension patients with T2 DM.