影响2型糖尿病利拉鲁肽疗效的代谢因素分析

Metabolic factors influencing the efficacy of liraglutide in type 2 diabetes mellitus

目的不同的患者使用利拉鲁肽的治疗效果具有明显差异。文章探讨2型糖尿病患者使用利拉鲁肽治疗后的疗效及疗效的影响因素。方法回顾性分析2019年4月-2020年9月入住东部战区总医院内分泌科的57例患有2型糖尿病,且首次使用利拉鲁肽治疗患者临床资料。以患者临床指标为依据,适当调整利拉鲁肽的用药剂量,其初始剂量为每日0.6 mg,最大剂量不能超过1.8 mg/d,观察时间设定为8周。收集治疗前相关临床数据,随访用药8周后的空腹血糖及空腹体重数据,使用Spearman相关性分析研究利拉鲁肽疗效的影响因素。结果利拉鲁肽可显著降低患者的空腹血糖[(8.0±2.4)mmol/L vs(6.9±1.8)mmol/L]及体重[(80.4±11.6)kg vs(76.5±11.4)kg],差异均有统计学意义(P<0.01);胰岛β细胞功能指数、单核细胞计数和钠离子浓度与血糖下降程度呈正相关(P<0.05);而C反应蛋白、三酰甘油、丙氨酸氨基转移酶呈负相关(P<0.05)。结论在临床实践过程中,利拉鲁肽降糖、减重疗效显著,特别是胰岛B功能指数越高,C反应蛋白、三酰甘油、丙氨酸氨基转移酶水平越低的2型糖尿病患者,其血糖下降水平越明显。

Objective The treatment effect of liraglutide varies significantly in different patients.To investigate the efficacy and influencing factors of liraglutide in patients with type 2 diabetes mellitus(T2DM).Methods The clinical data of 57 patients with T2DM who were admitted to the Department of Endocrinology,General Hospital of Eastern Theater Command from April 2019 to September 2020 and were treated with liraglutide for the first time were retrospectively analyzed.According to the clinical indicators of patients,the dose of liraglutide was adjusted appropriately.The initial dose was 0.6mg per day,and the maximum dose was not more than 1.8mg/day.The observation time was set as 8 weeks.Clinical data before treatment,fasting blood glucose and fasting body weight data after 8 weeks of follow-up were collected.Spearman correlation analysis was used to study the influencing factors of the efficacy of liraglutide.Results Liraglutide could significantly reduce fasting blood glucose[(8.0±2.4)mmol/L vs(6.9±1.8)mmol/L]and body weight[(80.4±11.6)kg vs(76.5±11.4)kg],and the differences were statistically significant(P<0.01).β-cell function index,monocyte count and sodium concentration were positively correlated with the degree of blood glucose decline(P<0.05).C-reactive protein,triacylglycerol and alanine aminotransferase were negatively correlated(P<0.05).Conclusion In the process of clinical practice,Lilalutide has significant effects on reducing blood glucose and weight loss,especially in type 2 diabetes patients with higher islet B function index and lower levels of C-reactive protein,triglyceride and alanine aminotransferase,their blood glucose levels will decline more significantly.