利拉鲁肽在2型糖尿病伴肥胖患者中的应用效果

Effect of Liraglutide on Type 2 Diabetes Mellitus with Obesity

目的分析利拉鲁肽在2型糖尿病伴肥胖患者中的应用效果。方法选取2020年7月至2021年7月滁州市第一人民医院内分泌科收治的80例2型糖尿病患者,按照治疗方法不同分为对照组(口服二甲双胍缓释片)和试验组(口服二甲双胍缓释片基础上皮下注射利拉鲁肽),每组40例。治疗12周后,比较两组患者治疗前后空腹血糖、餐后2 h血糖、糖化血红蛋白(HbA_(1c))、空腹C肽及空腹胰岛素(FINS)、体质量指数(BMI)、血清总胆固醇、三酰甘油、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平以及不良反应发生情况。结果空腹血糖、餐后2 h血糖、HbA_(1c)、空腹C肽、FINS、BMI以及血清总胆固醇、三酰甘油、LDL-C、HDL-C时点间和组间的主效应差异有统计学意义(P<0.05或P<0.01),空腹血糖、HbA_(1c)、血清三酰甘油、LDL-C的时点间与组间不存在交互作用(P>0.05),餐后2 h血糖、空腹C肽、FINS、BMI、血清总胆固醇、HDL-C的时点间与组间存在交互作用(P<0.05或P<0.01),治疗后试验组空腹血糖、餐后2 h血糖、HbA_(1c)、BMI以及血清总胆固醇、三酰甘油、LDL-C水平低于对照组(P<0.05),空腹C肽、FINS、HDL-C高于对照组(P<0.05),且试验组变化更明显。试验组与对照组不良反应发生率比较差异无统计学意义[40.0%(16/40)比32.5%(13/40)](χ2=0.487,P=0.485)。结论在口服二甲双胍缓释片的基础上皮下注射利拉鲁肽能够有效控制2型糖尿病伴肥胖患者的血糖以及血脂水平,显著降低患者体质量。

Objective To analyze the application effect of liraglutide in patients with type 2 diabetes mellitus and obesity.Methods A total of 80 patients with type 2 diabetes admitted to the Department of Endocrinology,the First People′s Hospital of Chuzhou from Jul.2020 to Jul.2021 were included and divided into a control group(oral metformin sustained-release tablets)and a test group(oral metformin sustained-release tablets plus subepithelial injection of liraglutide)according to the treatment method,with 40 cases in each group.After 12 weeks of treatment,the fasting blood glucose,2 h postprandial blood glucose,glycosylated hemoglobin(HbA_(1c)),fasting C-peptide and fasting insulin(FINS),body mass index(BMI),serum total cholesterol,triglyceride and high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)before and after treatment,as well as the incidence of adverse actions were compared between the two groups.Results The main effect differences of fasting blood glucose,2 h postprandial blood glucose,HbA_(1c),fasting C-peptide,FINS,BMI,serum total cholesterol,triglyceride,LDL-C,HDL-C before and after treatment and between the two groups were statistically significant(P<0.05 or P<0.01);there was no interaction in fasting blood glucose,HbA_(1c),serum triacylglycerol,LDL-C between time points and groups(all P>0.05).There were interactions in 2 h postprandial blood glucose,fasting C-peptide,FINS,BMI,serum total cholesterol,HDL-C between time points and groups(P<0.05 or P<0.01).After treatment,fasting blood glucose,2 h postprandish blood glucose,HbA_(1c),BMI,serum total cholesterol,triglyceride and LDL-C levels of experimental groups were lower than those of control group(P<0.05),while fasting C-peptide,FINS and HDL-C levels of experimental groups were higher than those of control group(P<0.05),and the changes were more significant in the test group.There was no significant difference in the incidence of adverse reactions between the two groups[40.0%(16/40)vs 32.5%(13/40)](χ2=0.487,P=0.485).Conclusion The subepithelial injection of liraglutide based on oral metformin sustained-release tablets can effectively control blood glucose and lipid levels in patients with type 2 diabetes mellitus and obesity,and significantly reduce body weight of the patients.