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1. 衡水市人民医院内分泌科
2. 衡水市人民医院核医学科
纸质出版日期:2021,
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[1]赵正历,冯玉俊,耿建林,谷巍,张雪坤.利拉鲁肽与格列美脲对胰岛素泵治疗欠佳2型糖尿病患者的安全性和血管获益的对比研究[J].中国医院用药评价与分析,2021,21(04):428-431.
ZHAO Zhengli, FENG Yujun, GENG Jianlin, et al. Comparative Study on Safety and Vascular Benefits of Liraglutide and Glimepiride in Patients with Inadequately Glycemic Controlled Type 2 Diabetes with Insulin Pump[J]. 2021,21(4):428-431.
[1]赵正历,冯玉俊,耿建林,谷巍,张雪坤.利拉鲁肽与格列美脲对胰岛素泵治疗欠佳2型糖尿病患者的安全性和血管获益的对比研究[J].中国医院用药评价与分析,2021,21(04):428-431. DOI: 10.14009/j.issn.1672-2124.2021.04.011.
ZHAO Zhengli, FENG Yujun, GENG Jianlin, et al. Comparative Study on Safety and Vascular Benefits of Liraglutide and Glimepiride in Patients with Inadequately Glycemic Controlled Type 2 Diabetes with Insulin Pump[J]. 2021,21(4):428-431. DOI: 10.14009/j.issn.1672-2124.2021.04.011.
目的:探讨胰岛素泵治疗欠佳的2型糖尿病患者分别采用利拉鲁肽与格列美脲治疗的效果以及不良反应。方法:选择2018年8月至2020年8月衡水市人民医院治疗的2型糖尿病住院患者166例
且患者持续给予皮下注射胰岛素泵(胰岛素用量> 0.7 IU/kg)治疗7 d后血糖仍然不达标
采用随机数字法分为研究组(n=84)和对照组(n=82)。对照组患者给予格列美脲治疗
研究组患者给予利拉鲁肽治疗。记录两组患者治疗前、治疗3个月后外周血生化指标[糖化血红蛋白(Hb A1c)、空腹血糖(FBG)、餐后2 h血糖(2 h PG)、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)、脂蛋白相关磷脂酶A2(Lp-PLA2)及超敏C反应蛋白(hs-CRP)]、胰岛素相关指标[空腹胰岛素(FINS)、胰岛素抵抗指数(HOMAIR)]、肾功能指标[血尿酸(SUA)、肌酐(SCr)、尿蛋白排泄率(UAER)及尿微量白蛋白/尿肌酸肝(ACR)]水平
双下肢血管功能[血管内膜中层厚度(IMT)、收缩期血管峰值血流(PSV)及狭窄率]和不良反应。结果:治疗3个月后
两组患者Hb A1c、FBG、2h PG、TG、TC、LDL-C、Lp-PLA2及hs-CRP等生化指标水平较治疗前显著降低
HDL-C水平较治疗前明显升高;研究组患者Hb A1c、FBG、2 h PG、TG、TC、LDL-C、Lp-PLA2、hs-CRP等生化指标水平与对照组相比明显降低
HDL-C水平与对照组相比明显升高
上述差异均有统计学意义(P <0.05)。治疗3个月后
两组患者FINS、HOMA-IR等指标水平较治疗前明显降低
且研究组患者FINS、HOMA-IR等指标水平降低程度明显优于对照组
差异均有统计学意义(P <0.05)。治疗3个月后
两组患者UAER、SCr、SUA及ACR等肾功能指标水平
IMT、PSV及狭窄率等血管功能指标水平明显低于治疗前;且研究组患者上述肾功能指标、血管功能指标水平明显低于对照组
差异均有统计学意义(P <0.05)。两组患者治疗后未见严重不良反应。结论:胰岛素泵治疗欠佳2型糖尿病患者联合应用利拉鲁肽治疗的疗效优于格列美脲
利拉鲁肽对患者血糖、血脂、胰岛功能及肾功能的改善效果更显著
且安全性高。
OBJECTIVE: To probe into the effects of liraglutide and glimepiride in the treatment of patients with inadequately glycemic controlled type 2 diabetes with insulin pump and its adverse drug reactions. METHODS: Totally166 patients with type 2 diabetes admitted into Hengshui People’s Hospital from Aug. 2018 to Aug. 2020 were extracted
after 7 d of continuous treatment with subcutaneous insulin pump( insulin dosage > 0. 7 IU/kg)
the blood glucose was still not up to standard. All patients were divided into the research group( n = 84) and the control group( n = 82) via the random number table. The control group was treated with glimepiride
while the research group received liraglutide. Peripheral blood biochemical indicators [glycated hemoglobin( HbA1 c)
fasting blood glucose( FBG)
2 h postprandial blood glucose( 2 h PG)
triglycerides( TG)
total cholesterol( TC)
high-density lipoprotein cholesterol( HDL-C)
low-density lipoprotein cholesterol( LDL-C)
lipoprotein-related phospholipase A2( Lp-PLA2) and high-sensitivity C-reactive protein( hs-CRP) ]
insulin-related indicators [fasting insulin( FINS)
homeostasis model assessment of insulin resistance( HOMA-IR) ]
renal function indicators [serum uric acid( SUA)
creatinine( SCr)
urinary protein excretion rate( UAER) and urine microalbumin/urinary creatine liver( ACR) ]and vascular function of both lower limbs [intravascular median membrane thickness( IMT)
peak systolic velocity( PSV)and stenosis rate] and adverse drugs reactions of two groups were recorded before treatment and after treatment of3 months. RESULTS: After treatment of 3 months
the levels of HbA1 c
FBG
2 h PG
TG
TC
LDL-C
Lp-PLA2 and hs-CRP in two groups were significantly lower than those before treatment
while the levels of HDL-C were significantly higher than those before treatment; compared with the control group
the levels of HbA1 c
FBG
2 hPG
TG
TC
LDL-C
Lp-PLA2
hs-CRP and other biochemical indicators in the research group decreased significantly
while the levels of HDL-C increased significantly
with statistically significant difference( P < 0. 05). After treatment of 3 months
the levels of FINS
HOMA-IR and other indicators in two groups were significantly lower than those before treatment
and the levels of FINS and HOMA-IR in the research group were significantly lower than those in the control group
and the differences were statistically significant( P < 0. 05). After treatment of 3 months
the levels of renal function indicators such as UAER
SCr
SUA and ACR
and vascular function indicators such as IMT
PSV and stenosis rate of two groups were significantly lower than those before treatment; and the levels of the above renal function indicators and vascular function indicators of the research group were significantly lower than those of the control group
the differences were statistically significant( P < 0. 05). There were no severe adverse drug reactions in two groups after treatment. CONCLUSIONS: The efficacy of insulin pump combined with liraglutide is better than glimepiride in the treatment of patients with type 2 diabetes. Liraglutide has a more significant effect on blood glucose
blood lipids
islet function and renal function
and has higher safety.
利拉鲁肽格列美脲胰岛素2型糖尿病
LiraglutideGlimepirideInsulinType 2 diabetes
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