度拉糖肽治疗对2型糖尿病合并骨质疏松患者的治疗效果

Effects of dula glucopeptide treatment on type 2 diabetes mellitus with osteoporosis

目的:探究度拉糖肽对2型糖尿病(Diabetes mellitus Type2,T2DM)合并骨质疏松患者的治疗效果。方法:选取我科2020年1月至2021年4月期间80例2型糖尿病合并骨质疏松患者为研究对象,根据随机数字分组法分为对照组和观察组(n=40),对照组患者口服阿仑膦酸钠、口服维生素D3、皮下注射门冬胰岛素30等治疗,观察组患者在此基础上皮下注射度拉糖肽1.5 mg,治疗3 m后检测患者空腹血糖指数(Fasting plasma glucose,FPG)、餐后2 h血糖指数(2h postprandial blood glucose,2hPG);应用全自动血糖血红蛋白分析仪检测患者糖化血红蛋白(Glycosylated hemoglobin,HbA1c);应用便携式超声骨密度仪及电化学发光法检测患者骨密度(Bone mineral density,BMD)、骨钙素(Osteocalcin,OC)、1型胶原氨基端延长肽(Type 1 collagen amino terminal lengthening peptide,P1NP)和β-胶原降解产物(Beta-collagen degradation products,β-CTX);应用全自动分析仪及酶联免疫吸附法检测碱性磷酸酶(Alkaline phosphatase,ALP)、骨特异性碱性磷酸酶(Bone-specific alkaline phosphatase,BAP)、护骨素(Protection of bone,OPG);并计算对比患者治疗后恶心、呕吐、腹泻、低血糖的发生率。结果:治疗3个月后观察组患者FPG、2hPG、HbA1c水平小于对照组(P<0.05);治疗3个月后观察组患者BMD、OC水平大于对照组,P1NP、β-CTX水平小于对照组(P<0.05);治疗3个月后观察组患者ALP、BAP、OPG水平大于对照组(P<0.05);治疗期间两组患者出现恶心、呕吐、腹泻、低血糖等不良反应的人数无明显差异(P>0.05)。结论:度拉糖肽可以增强对2型糖尿病合并骨质疏松患者的临床治疗效果,改善其骨质疏松相关因子水平,降低骨代谢速度。

Objective:To explore the therapeutic effect of dula glucopeptide on patients with Type2 Diabetes mellitus(T2DM)complicated with osteoporosis.Methods:Eighty patients with type 2 diabetes mellitus complicated with osteoporosis in our department from January 2020 to April 2021 were selected and divided into two groups(n=40)according to random number group.The patients in control group were treated with alendronate sodium,oral vitamin D3 and subcutaneous insulin aspartate 30.The patients in observation group were injected with 1.5 mg of dula glucopeptide in basal subepithelium,and fasting glucose index and 2 h postprandial glucose index were detected 3 m after treatment.Automatic blood glucose hemoglobin analyzer was used to detect hBA1c in patients.Bone mineral density(BMD),osteocalcin(OC),amino-terminal-lengthened peptide of type 1 collagen(P1NP)and degradation products ofβ-collagen(β-CTX)were determined by portable ultrasonic bone density analyzer and electrochemiluminescence.Automatic analyzer and ELISA were used to detect alkaline phosphatase(ALP),bone-specific alkaline phosphatase(BAP)and protection of bone(OPG).The incidence of nausea,vomiting,diarrhea and hypoglycemia after treatment was calculated and compared.Results:After 3 months of treatment,the levels of FPG,2hPG and HbA1c in observation group were lower than those in control group(P<0.05).After 3 months of treatment,BMD and OC levels in observation group were higher than those in control group,while P1NP andβ-CTX levels were lower than those in control group(P<0.05).After 3 months of treatment,ALP,BAP and OPG levels in observation group were higher than those in control group(P<0.05).During treatment,there was no significant difference in the number of adverse reactions such as nausea,vomiting,diarrhea and hypoglycemia between 2 groups(P>0.05).Conclusion:Dula glucopeptide can enhance the clinical treatment effect for patients with type 2 diabetes mellitus complicated with osteoporosis,improve the level of osteoporosis related factors and reduce the rate of bone metabolism.