2019 年第 7 期 第 14 卷

利拉鲁肽治疗2型糖尿病合并肥胖患者的临床效果

Clinical effect of liraglutide on patients with type 2 diabetes mellitus and obesity

作者：叶夏云赵金英韩凤霞

英文作者：

单位：730050兰州，解放军联勤保障部队第九四〇医院内分泌科

英文单位：

关键词：2型糖尿病；利拉鲁肽；肥胖

英文关键词：

• 摘要：

• 【摘要】目的    探讨利拉鲁肽对2型糖尿病合并肥胖患者的临床疗效。方法    选取2016年1月至2018年1月于解放军联勤保障部队第九四〇医院确诊的2型糖尿病合并肥胖患者46例，均为使用2种口服降糖药物(均使用二甲双胍)治疗效果不佳者。采用随机数字表法分为观察组（24例）与对照组（22例）。对照组在原口服药物治疗基础上加用甘精胰岛素注射液治疗；观察组在原口服药物治疗基础上加用利拉鲁肽治疗。比较2组患者治疗前和治疗24周后空腹血糖、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)和体重指数。结果    2组患者治疗前空腹血糖、2 h PG、HbA1c及体重指数比较，差异均无统计学意义（均P＞0.05）。2组患者治疗24周后空腹血糖、2 h PG、HbA1c均明显下降，与治疗前相比差异有统计学意义(均P＜0.05）。治疗24周后，观察组2 h PG、HbA1c均明显低于对照组，空腹血糖明显高于对照组［（7.6±1.5）mmol/L比（8.6±1.9）mmol/L、（6.3±1.2）%比（7.1±1.4）%、（7.2±2.0）mmol/L比（6.0±2.0）mmol/L］，差异均有统计学意义(t=2.053、2.086、2.033，P=0.046、0.043、0.048）。对照组体重指数治疗前后比较差异无统计学意义（P＞0.05），观察组治疗24周后体重指数明显低于治疗前，且明显低于对照组［（25±5）kg/m2比（29±4）kg/m2］，差异均有统计学意义(均P＜0.01）。结论    利拉鲁肽在降低2型糖尿病合并肥胖患者血糖的同时还能减轻体质量。

• 【Abstract】Objective    To observe the therapeutic effect of liraglutide on patients with type 2 diabetes mellitus and obesity. Methods    From January 2016 to January 2018, 46 obese patients with type 2 diabetes with poor response to metformin were enrolled in the 940th Hospital of Joint Logistics Support Force of Chinese People′s Liberation Army. The patients were randomly divided into observation group（24 cases） and control group（22 cases）. The control group was treated with metformin plus insulin glargine injection. The observation group was treated with metformin plus liraglutide. Fasting plasm glucose(FBG), 2 h postprandial blood glucose (2 h PG), glycosylated hemoglobin（HbA1c） and body mass index(BMI) were analyzed before and 24 weeks after treatment. Results    There was no significant difference of FBG, 2 h PG, HbA1c and BMI between groups before treatment(all P＞0.05). Levels of FBG, 2 h PG and HbA1c decreased significantly after 24 weeks of treatment in both groups (all P＜0.05). After treatment, levels of 2 h PG and HbA1c in observation group were significantly lower and FBG was significantly higher than those in control group［（7.6±1.5）mmol/L vs （8.6±1.9）mmol/L, （6.3±1.2）% vs （7.1±1.4）%, （7.2±2.0）mmol/L vs （6.0±2.0）mmol/L］(t=2.053, 2.086, 2.033; P=0.046, 0.043, 0.048）. BMI showed no significant changes in control group(P＞0.05). BMI in observation group after treatment was significantly lower than that before treatment and that in control group［（25±5）kg/m2 vs （29±4）kg/m2］(both P＜0.01). Conclusion    Liraglutide can effectively control blood glucose and reduce body weight in patients with type 2 diabetes and obesity.