恩格列净、利拉鲁肽联合二甲双胍治疗2型糖尿病的效果及对胰岛功能、血管内皮功能的影响比较

Comparison of the effect of empagliflozin, liraglutide combined with metformin in the treatment of type 2 diabetes mellitus and their influences on islet function and vascular endothelial function

目的比较恩格列净、利拉鲁肽联合二甲双胍治疗2型糖尿病的效果及对胰岛功能、血管内皮功能的影响。方法选取2021年1月至2022年12月收治的98例2型糖尿病患者作为研究对象,随机将其分为A组和B组,各49例。A组采用利拉鲁肽联合二甲双胍治疗,B组采用恩格列净联合二甲双胍治疗。比较两组治疗前、后的血糖、胰岛功能及血管内皮功能指标。结果治疗后,A组的空腹血糖(FPG)、餐后2 h血糖(2 h PG)水平及糖化血红蛋白(HbA1c)低于B组,差异具有统计学意义(P<0.05)。治疗后,A组的胰岛素抵抗指数(HOMA-IR)低于B组,胰岛素β细胞功能指数(HOMA-β)高于B组,差异具有统计学意义(P<0.05)。治疗后,A组的脂联素(ADP)、一氧化氮(NO)水平高于B组,内皮素(ET)水平低于B组,差异具有统计学意义(P<0.05)。结论与恩格列净联合二甲双胍治疗2型糖尿病相比,利拉鲁肽联合二甲双胍能提高血糖控制效果,促进胰岛功能、血管内皮功能改善,值得推广。

Objective To compare the effect of empagliflozin,liraglutide combined with metformin in the treatment of type 2 diabetes mellitus and their influences on islet function and vascular endothelial function.Methods A total of 98 patients with type 2 diabetes mellitus admitted from January 2021 to December 2022 were selected as the research objects and randomly divided into group A and group B,with 49 cases in each group.The group A was treated with liraglutide combined with metformin,and the group B was treated with empagliflozin combined with metformin.The blood glucose,islet function and vascular endothelial function indexes before and after treatment were compared between the two groups.Results After treatment,the fasting plasma glucose(FPG),2 h postprandial plasma glucose(2 h PG)levels and glycosylated hemoglobin(HbA1c)in the group A were lower than those in the group B,and the differences were statistically significant(P<0.05).After treatment,the homeostatic model assessment-insulin resistance(HOMA-IR)in the group A was lower than that in the group B,and the homeostasis model assessment-β(HOMA-β)was higher than that in the group B,and the differences were statistically significant(P<0.05).After treatment,the levels of adiponectin(ADP)and nitric oxide(NO)in the group A were higher than those in the group B,and the level of endothelin(ET)was lower than that in the group B,and the differences were statistically significant(P<0.05).Conclusion Compared with empagliflozin combined with metformin in the treatment of type 2 diabetes mellitus,liraglutide combined with metformin can improve the effect of blood glucose control,promote the improvement of islet function and vascular endothelial function,which is worthy of promotion.