艾塞那肽在糖调节受损的青少年肥胖患者中的近、远期效果的临床研究  

Nearly and long-term clinical effect of exenatide in obese adolescents with abnormal glucose metabolism

作　　者：黄昭穗[1] 黄昭瑄[1] 杨骄[1] 栾丽丽[1] 王赐玉[1] 杨红英[1] 

机构地区：[1]厦门大学附属成功医院内分泌科,厦门361003

出　　处：《中国临床药理学杂志》2015年第14期1390-1392,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的评价艾塞那肽在肥胖青少年糖代谢异常中的近、远期效果观察。方法入选92例糖代谢异常的青少年肥胖患者,随机分为对照组45例和试验组47例,对照组口服盐酸二甲双胍0.5 g,每日3次;试验组口服盐酸二甲双胍0.5 g,每日3次,加皮下注射艾塞那肽,疗程为6个月。近期观察2组治疗前后患者体重、腰围、体质指数、空腹血糖、餐后2 h血糖(2 h PG)、糖化血红蛋白、收缩压、舒张压、三酰甘油、总胆固醇、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及空腹胰岛素、胰岛素抵抗水平(Homa IR)、胰岛β细胞功能指数(HOMA-β)。远期观察2组患者3年后糖尿病、高血压病发生情况。结果治疗后,试验组体重、腰围、体质指数有明显改善(P<0.01),餐后2 h血糖、糖化血红蛋白较治疗前明显改善(均P<0.05);三酰甘油、总胆固醇、LDL-C明显降低(均P<0.05);收缩压明显降低(P<0.05);空腹胰岛素、胰岛素敏感指数、HOMA-IR明显降低,HOMA-β升高(均P<0.01)。治疗后,试验组较对照组改善更明显(P<0.01)。结论艾塞那肽能明显减轻体重,改善内分泌代谢,减少因肥胖带来的代谢性异常的疾病发生。Objective To investigate the nearly and long-term effect of exenatide in obese adolescents with abnormal glucose metabolism.Methods A total of 92 cases of obese adolescents with abnormal glucose metabolism were randomly divided into two groups. Patients in the control group（ 45 cases） were treated with metformin 0. 5 g tid. And those in the trial group（ 47 cases） were treated with metformin 0. 5 g tid combined with exenatide ih for 6 months. The data of body weight,waist circumference,body mass index（ BMI）,fasting plasma glucose（ FPG）,2-hour postprandial blood glucose（ 2 h PG）,glycated hemoglobin（ Hb A1c）,systolic blood pressure（ SBP）,diastolic blood pressure（ DBP）,triglyceride（ TG）,total cholesterol（ TC）,high density lipoprotein cholesterol（ HDL-C）,low density lipoprotein cholesterol（ LDL-C）,and fasting insulin（ FINS）,insulin resistance（ HOMA-IR）,as well as pancreatic β-cell function index（ HOMA-β） were determined before and after the treatment between two groups. The incidence rate of diabetes and hypertension were observed after three years in long-term study. Results There were significant decreases in the body weight,waist circumference and BMI in trial group（ P〈0. 01）. Compared with those in control group and themselves before treatment,there were significant decreases in 2h PG、Hb A1c（ P〈0. 05）. The data of TC,LDL-C,TG were decreased in trial group（ P〈0. 05）. The SBP was significantly decreased in trial group,compared with those in control group,there was statistical significant difference（ P〈0. 05）. The FINS,ISI,HOMA-IR were decreased in trial group while the HOMA-β was increased（ P〈0. 01）,compared with those in control group and themselves before treatment,the difference was statistically significant（ P〈0. 05）. Conclusion Exenatide can significantly reduce body weight,improve endocrine metabolism and reduce the incidence of metabolic abnormalities disease caused by obesity.

关 键 词：艾塞那肽 糖调节受损 青少年 肥胖 

分 类 号：R587.1[医药卫生—内分泌]