摘要
目的 探究利拉鲁肽联合地特胰岛素治疗二甲双胍控制不佳的肥胖2型糖尿病患者的疗效。方法 80例二甲双胍控制不佳的肥胖2型糖尿病患者,均采用利拉鲁肽联合地特胰岛素治疗。对比患者治疗前后生化指标[体质量指数(BMI)、体质量、空腹血糖(FPG)、餐后2 h血糖(2 h PG)、空腹C肽(FCP)、餐后2 h C肽(2 h CP)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)、谷草转氨酶(AST)、空腹胰岛素(FINS)、餐后2 h胰岛素(2 h INS)]。结果 治疗后,患者BMI(29.14±2.10)kg/m2、体质量(85.31±1.13)kg、FPG(6.31±1.28)mmol/L、2 h PG(10.21±1.39)mmol/L、HbA1c(7.16±1.10)%、TG(2.85±0.61)mmol/L、TC(4.98±1.03)mmol/L、LDL-C(2.74±0.19)mmol/L、HOMA-IR(1.28±0.41)、AST(22.13±8.51)U/L均低于治疗前的(30.41±2.51)kg/m2、(87.52±1.84)kg、(10.52±2.62)mmol/L、(15.61±4.85)mmol/L、(8.61±1.29)%、(3.61±0.29)mmol/L、(5.61±1.29)mmol/L、(3.72±0.29)mmol/L、(1.49±0.61)、(25.41±10.26)U/L, FCP(3.61±2.30)ng/ml、2 h CP(13.25±3.25)ng/ml、HDL-C(1.46±0.39)mmol/L、HOMA-β(4.10±0.89)、FINS(85.63±10.32)pmol/L、2 h INS(102.30±10.62)pmol/L高于治疗前的(2.81±1.64)ng/ml、(6.31±2.28)ng/ml、(1.02±0.14)mmol/L、(3.52±0.75)、(65.61±10.29)pmol/L、(80.56±10.82)pmol/L,差异均有统计学意义(P<0.05)。结论 利拉鲁肽与地特胰岛素联合应用治疗二甲双胍控制不佳肥胖2型糖尿病的临床疗效确切,可有效改善血糖、血脂水平,在降低肥胖患者BMI的同时无明显低血糖情况发生,此治疗方案可供临床采纳。
Objective To investigate the efficacy of liraglutide combined with insulin detemir in the treatment of obese patients with type 2 diabetes mellitus poorly controlled by metformin.Methods 80 obese patients with type 2 diabetes melitus poorly controlled by metformin were treated with liraglutide combined with insulin detemir.Biochemical indicators[body mass index(BMI),body weight,fasting plasma glucose(FPG),2 h postprandial glucose(2 h PG),fasting C peptide(FCP),postprandial 2 h C peptide(2 h CP),glycosylated hemoglobin(HbA1c),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),homeostasis model assessment insulin resistance index(HOMA-IR),homeostasis model assessment pancreatic-βcells function(HOMA-β),aspartate aminotransferase(AST),fasting insulin(FINS),2-h postprandial insulin(2 h INS)]before and after treatment were compared.Results After treatment,the BMI was(29.14±2.10)kg/m2,body weight was(85.31±1.13)kg,FPG was(6.31±1.28)mmol/L,2 h PG was(10.21±1.39)mmol/L,HbA1c was(7.16±1.10)%,TG was(2.85±0.61)mmol/L,TC was(4.98±1.03)mmol/L,LDL-C was(2.74±0.19)mmol/L,HOMA-IR was(1.28±0.41),AST was(22.13±8.51)U/L,which were lower than(30.41±2.51)kg/m2,(87.52±1.84)kg,(10.52±2.62)mmol/L,(15.61±4.85)mmol/L,(8.61±1.29)%,(3.61±0.29)mmol/L,(5.61±1.29)mmol/L,(3.72±0.29)mmol/L,(1.49±0.61),(25.41±10.26)U/L before treatment;the FCP was(3.61±2.30)ng/ml,2 h CP was(13.25±3.25)ng/ml,HDL-C was(1.46±0.39)mmol/L,HOMA-βwas(4.10±0.89),FINS was(85.63±10.32)pmol/L,2 h INS was(102.30±10.62)pmol/L,which were higher than(2.81±1.64)ng/ml,(6.31±2.28)ng/ml,(1.02±0.14)mmol/L,(3.52±0.75),(65.61±10.29)pmol/L,(80.56±10.82)pmol/L before treatment;all the differences were statistically significant(P<0.05).Conclusion Liraglutide combined with insulin detemir has definite clinical efficacy in the treatment of obese patients with type 2 diabetes mellitus poorly controlled by metformin,which can effectively improve the blood glucose and blood lipid level
作者
王璇
WANG Xuan(Tieling Central Hospital,Tieling 112000,China)
出处
《中国实用医药》
2022年第13期120-122,共3页
China Practical Medicine
