论文部分内容阅读
目的观察评价长期应用利拉鲁肽治疗T2DM患者的疗效及血糖、血脂、血压及颈动脉粥样硬化斑块大小的影响。方法血糖控制不佳的T2DM患者97例,随机分为利拉鲁肽(LIR)组(n=49)和胰岛素(Ins)组(n=48)。LIR组应用地特胰岛素联合利拉鲁肽皮下注射;Ins组应用诺和锐联合地特胰岛素皮下注射,比较治疗前后两组血糖、血脂、C-P、BMI、BP、颈动脉粥样硬化斑块大小等指标。结果治疗3.2年后,两组FPG、2hPG、HbA1c比较,差异无统计学意义(P>0.05);LIR组BMI降低,Ins组升高。LIR组FC-P[(4.73±2.39)vs(2.72±1.57)ng/ml,P<0.01]、2hC-P[(13.33±3.39)vs(6.93±2.2)ng/ml,P<0.01]高于Ins组。LIR组TC[(4.19±0.48)vs(5.11±1.51)mmol/L,P<0.01]、LDL-C[(2.55±0.64)vs(3.13±0.73)mmol/L,P<0.01]、SBP[(126.55±10.08)vs(137.22±27.42)mmHg,P<0.01]、DBP[(78.22±6.45)vs(85.60±9.54)mmHg,P<0.05]低于Ins组。LIR组治疗后颈动脉斑块大小较治疗前降低[(0.57±0.26)vs(0.22±0.10)cm,P<0.01],Ins组则升高[(0.52±0.27)vs(0.83±0.34)cm,P<0.01]。结论利拉鲁肽联合地特胰岛素能降低FPG、2hPG,改善胰岛细胞功能、血脂、血压;利拉鲁肽能够促使糖尿病患者颈动脉粥样硬化斑块厚度减低,具有逆转动脉粥样硬化斑块的作用。
Objective To observe the long-term effect of liraglutide in the treatment of T2DM patients and the effects of blood glucose, blood lipids, blood pressure and carotid atherosclerosis plaque size. Methods A total of 97 T2DM patients with poor glycemic control were randomly divided into liraglutide (LIR) group (n = 49) and Ins group (n = 48). LIR group was treated with insulin dextrose combined with liraglutide subcutaneously. Ins group was injected subcutaneously with Novolin and insulin detemir, and blood glucose, blood lipid, CP, BMI, BP, carotid atherosclerosis plaque size And other indicators. Results After treatment for 3.2 years, there was no significant difference in FPG, 2hPG and HbA1c between the two groups (P> 0.05). The BMI of LIR group was decreased and the Ins group was increased. The levels of FC-P in LIR group (4.73 ± 2.39 vs 2.72 ± 1.57 ng / ml, P <0.01) and 2 hC-P [(13.33 ± 3.39) vs 6.93 ± 2.2 In Ins group. L [(4.19 ± 0.48) vs (5.11 ± 1.51) mmol / L, P <0.01], LDL-C [2.55 ± 0.64 vs 3.13 ± 0.73 mmol / L, P <0.01] (126.55 ± 10.08) vs (137.22 ± 27.42) mmHg, P <0.01], DBP [(78.22 ± 6.45) vs (85.60 ± 9.54) mmHg, P <0.05] The carotid plaque size in the LIR group was significantly lower than that before treatment [(0.57 ± 0.26) vs (0.22 ± 0.10) cm, P <0.01], while the Ins group increased (0.52 ± 0.27) vs (0.83 ± 0.34) cm , P <0.01]. Conclusion Liraglutide combined with insulin dextrins can reduce FPG, 2hPG, improve islet cell function, blood lipids, blood pressure; liraglutide can promote diabetic patients with reduced atherosclerotic plaque thickness, with atherosclerotic plaque reversal Role.