利拉鲁肽在血糖控制不佳的T2MD伴肥胖患者中临床疗效观察  

Clinical efficacy of liraglutide in corpulent T2DM patients with poor glycemic control

作　　者：黄昭穗[1] 杨骄[1] 黄昭瑄[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

出　　处：《中国临床药理学与治疗学》2016年第1期87-92,共6页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的:探讨利拉鲁肽在血糖控制不佳的2型糖尿病(T2DM)伴肥胖患者中临床疗效观察。方法:2013年3月至6月在本院内分泌门诊收治的T2DM伴肥胖患者54例,BMI≥25。随机分为利拉鲁肽治疗组和门冬胰岛素30对照组。于用药前、用药12周后分别测定患者的体质量、腰围、BMI、空腹血糖(FPG)、餐后2 h血糖(2h PG)、糖化血红蛋白(Hb A1c)、甘油三脂(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);对两组患者行72 h动态血糖监测(CGMS),比较24 h平均血糖水平(24 h MBG)、高血糖所占比率(HAVC)(≥11.1 mmol/L)、低血糖所占比率(LAVC)(≤3.9 mmol/L)、日平均达标率、最大血糖波动幅度(LAGS)、血糖波动系数(SDBG)、平均血糖波动幅度(MAGE)。治疗前后采用配对样本t检验,组间差异采用独立样本t检验。结果:(1)利拉鲁肽治疗组12周后体质量、腰围、BMI较治疗前明显降低,差异有统计学意义(P<0.01),对照组用药12周后体质量有增加趋势,腰围、BMI变化不明显(P>0.05)。两组间比较差异具有统计学意义(P<0.01)。(2)两组FPG、2h PG、Hb A1c在治疗后均有下降(P<0.05),两组间比较无差异(P>0.05)。所有患者治疗后各个时点血糖较治疗前均有下降,两组间比较差异无统计学意义(P>0.05)。(3)两组患者均出现TC、LDL-C、TG降低和HDL-C升高。两组间比较差异有统计学意义(P<0.05)。(4)动态血糖监测(CGMS)参数比较:治疗后两组患者LAGS、SDBG、MAGE、LAVC差异有统计学意义(P<0.05)。两组间比较差异具有统计学意义(P<0.05);治疗后两组患者24h MBG、HAVC、日平均达标率差异均有统计学意义(P<0.05),两组间比较差异无统计学意义(P>0.05)。结论:利拉鲁肽对于血糖控制不佳的2型糖尿病患者,在平稳降糖、减轻体质量、调脂等方面具有一定的疗效。AIM： To investigate the clinical efficacy of liraglutide in corpulent T2DM patients with poor glycemic control.METHODS： 54 patients who were diagnosed as type 2 diabetes with obesity were collected in this study from March 2013 to June2013.Patients were randomly divided into liraglutide-treatment group and Insulin Aspart 30 Injectioncontrol group.Body weight,waistline,BMI,fasting plasma glucose（ FPG）,2-hour postprandial blood glucose（2h PG）,glycated hemoglobin（HbA1c）,triglyceride（TG）, total cholesterol（ TC）, high density lipoprotein cholesterol（ HDL-C） and low density lipoprotein cholesterol（ LDL-C） were measured before medication and after 12 weeks.Glucose levels of the patients were monitored for 72 hours by glucose monitor（ USA Medtronic production）（ CGMS）.The 24-hour average blood glucose levels（ 24 h MBG）,high blood sugar percentage（ HAVC）（ ≥11.1 mmol/L）,the percentage of low blood sugar（ LAVC）（ ≤3.9 mmol/ L）,the daily average compliance rate,the maximum blood glucose fluctuations amplitude（ LAGS）,blood glucose fluctuation coefficient（ SDBG） and the mean amplitude of glycemic excursions（ MAGE） between the two groups were compared.Paired sample t-test was used for the results before and after treatment.Independent sample t-test was used for the results between groups.RESULTS：（ 1） The body weight,waistline,BMI were significantly improved in liraglutide-treatment groups after treatment for 12 weeks（ P 〈0.01）.After 12 weeks,the weight of the control group was increased,and there was no significantly change on waistline,BMI（ P 〈0.05）.The difference between two groups was significant（ P 〈0.01）.（ 2） The FPG,2h PG,HbA1 c were decreased in both of the two groups（ P 〈0.05）.There was no statistical significance difference between two groups（ P 〈0.05）.Glucose at each time points was decreased after medication.（ 3） The TC,TG,LDL-C were decreased,while the HDL-C was increased after treatment in the two g

关 键 词：利拉鲁肽 血糖控制不佳 2型糖尿病 肥胖 血糖波动 疗效 

分 类 号：R587.1[医药卫生—内分泌]