利拉鲁肽联合达格列净治疗肥胖2型糖尿病的疗效观察

Efficacy observation of liraglutide combined with dapagliflozin in the treatment of obese type 2 diabetes mellitus

目的观察利拉鲁肽联合达格列净治疗肥胖2型糖尿病的临床疗效。方法64例肥胖2型糖尿病患者,按照治疗方法不同分为对照组和实验组,各32例。对照组采用利拉鲁肽治疗,实验组采用利拉鲁肽联合达格列净治疗。比较两组患者治疗前后血糖指标、炎症指标、肾功能指标、体质量指数(BMI)及药物不良反应、糖尿病不良事件发生情况。结果治疗后,两组患者空腹血糖、餐后2 h血糖、糖化血红蛋白水平均低于治疗前,且实验组患者空腹血糖(5.95±0.21)mmol/L、餐后2 h血糖(6.13±1.37)mmol/L、糖化血红蛋白(6.15±0.23)%均低于对照组的(6.35±0.24)mmol/L、(7.15±1.32)mmol/L、(6.56±0.21)%,差异具有统计学意义(P<0.05)。治疗后,两组患者超敏C反应蛋白、肿瘤坏死因子-α、白细胞介素-6水平均低于治疗前,且实验组患者超敏C反应蛋白(6.42±0.31)mg/L、肿瘤坏死因子-α(24.32±1.32)ng/L、白细胞介素-6(104.34±4.54)pg/ml均低于对照组的(8.64±0.33)mg/L、(27.65±1.35)ng/L、(125.43±4.58)pg/ml,差异具有统计学意义(P<0.05)。治疗后,两组患者血肌酐、尿素氮水平均低于治疗前,且实验组患者血肌酐(104.54±2.32)μmol/L、尿素氮(6.45±1.43)mmol/L均低于对照组的(112.34±2.34)μmol/L、(8.65±1.45)mmol/L,差异具有统计学意义(P<0.05)。治疗后,两组患者体质量指数低于治疗前,且实验组患者体质量指数(30.43±1.32)kg/m2低于对照组的(31.34±1.35)kg/m2,差异有统计学意义(P<0.05)。实验组患者药物不良反应发生率9.38%略高于对照组的6.25%,但差异无统计学意义(P>0.05)。实验组患者糖尿病不良事件发生率为6.25%,低于对照组的31.25%,差异有统计学意义(P<0.05)。结论肥胖2型糖尿病应用利拉鲁肽与达格列净联合治疗效果显著优于单纯利拉鲁肽治疗,可有改善血糖水平、炎症反应、肾功能及体重情况,且安全性较高,值得临床推广。

Objective To observe the clinical efficacy of liraglutide combined with dapagliflozin in the treatment of obese type 2 diabetes mellitus.Methods A total of 64 obese patients with type 2 diabetes mellitus were divided into control group and experimental group according to different treatment methods,with 32 cases in each group.The control group was treated with liraglutide,and the experimental group was treated with liraglutide combined with dapagliflozin.Both groups were compared in terms of blood glucose indexes,inflammatory indexes,renal function indexes,and body mass index(BMI)before and after treatment,occurence of adverse drug reactions and diabetic adverse events.Results After treatment,the levels of fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin in the two groups were lower than those before treatment in this group;the fasting blood glucose(5.95±0.21)mmol/L,2 h postprandial blood glucose(6.13±1.37)mmol/L,and glycosylated hemoglobin(6.15±0.23)%in the experimental group were lower than(6.35±0.24)mmol/L,(7.15±1.32)mmol/L,and(6.56±0.21)%in the control group;the differences were all statistically significant(P<0.05).After treatment,the levels of high-sensitivity C-reactive protein,tumor necrosis factor-αand interleukin-6 in both groups were lower than those before treatment in this group;the high-sensitivity C-reactive protein(6.42±0.31)mg/L,tumor necrosis factor-α(24.32±1.32)ng/L,and interleukin-6(104.34±4.54)pg/ml in the experimental group were lower than(8.64±0.33)mg/L,(27.65±1.35)ng/L,and(125.43±4.58)pg/ml in the control group;the differences were all statistically significant(P<0.05).After treatment,the levels of serum creatinine and blood urea nitrogen in both groups were lower than those before treatment in this group;the serum creatinine(104.54±2.32)μmol/L and blood urea nitrogen(6.45±1.43)mmol/L in the experimental group were lower than(112.34±2.34)μmol/L and(8.65±1.45)mmol/L in the control group;the differences were all statistically significant(P<0.05).After treatment,the body mass index of the two groups was lower than that of this group before treatment,and the body mass index(30.43±1.32)kg/m2 of the experimental group was lower than(31.34±1.35)kg/m2 of the control group,and the differences were all statistically significant(P<0.05).The incidence of adverse drug reactions in the experimental group was 9.38%,which was slightly higher than 6.25%in the control group,the difference was not statistically significant(P>0.05).The incidence of diabetic adverse events in the experimental group was 6.25%,which was lower than 31.25%in the control group,and the difference was statistically significant(P<0.05).Conclusion The combined treatment of liraglutide and dagliflozin in obese type 2 diabetes mellitus is significantly better than liraglutide alone,which can improve blood glucose level,inflammatory response,renal function and weight,and has high safety,and is worthy of clinical promotion.