短期利拉鲁肽治疗与强化胰岛素治疗对2型糖尿病患者胰岛β细胞功能的影响  

Effect of short-term liraglutide therapy and intensive insulin therapy on β-cell function in type 2 diabetes mellitus

作　　者：杨杰[1] 高燕[2] 赵亮[1] 刘晶[1] 

机构地区：[1]泰安市中心医院内分泌科,山东271000 [2]中国人民解放军第八十八医院

出　　处：《社区医学杂志》2016年第6期11-13,共3页Journal Of Community Medicine

摘　　要：目的通过观察短期内利拉鲁肽与强化胰岛素治疗2型糖尿病患者前后空腹、60、120、180 min C-肽的变化,比较两种治疗方法对初发2型糖尿病患者胰岛β细胞功能的影响。方法选取2012年3月—2013年10月住院的初发2型糖尿病患者,并随机分为利拉鲁肽组和强化胰岛素组,利拉鲁肽组初始剂量为0.6 mg/d,每周加量0.6 mg,最大剂量为1.8 mg/d,强化胰岛素组起始剂量为0.5 U/(kg·d),根据血糖变化调整剂量,治疗20 d,于治疗前、后分别做口服葡萄糖耐量试验并测定C-肽释放曲线,将结果进行数据分析,计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果两组患者治疗20 d后,强化胰岛素组患者的血糖达标时间为(7.2±2.1)d,优于利拉鲁肽组的(10.1±2.6)d,对比差异有统计学意义(P<0.05),治疗后利拉鲁肽组患者在60、120、180 min的C-肽分别进行(4.21±0.97)、(7.14±1.12)、(5.38±1.08)nmol/L,均高于强化胰岛素组相应时间点的(3.57±0.98)、(6.56±0.95)、(4.95±1.02)nmol/L,对比差异均有统计学意义(均P<0.05)。治疗过程中利拉鲁肽组患者无低血糖事件发生。结论短期治疗时,在改善胰岛β细胞功能方面,利拉鲁肽治疗要优于强化胰岛素降糖治疗,更有利于长期血糖控制,同时具有良好的安全性。Objective By detecting the C- peptide level of new diagnosed type 2 diabetes mellitus before and after diffferent therapy（liraglutide and intensive insulin）,we want to found the difference of the effect of the two different therapy on the β- cell function.Methods New diagnosed type 2 diabetes mellitus patients in hospital from 2012.3 to 2013.10 were randomly divided into liraglutide group and intensive insulin group.C- peptide were detected before the therapy and after 20 days therapy with liraglutide or intensive insulin and the statistic analysis for the data were performed.Measurement data was processed by t test,count data was processed by chi sqare test,the result of P0.05 was considered statistically significant.Results After 20 days＇ therapy,the reduce speed to the target level of blood glucose in the intensive insulin group was faster than that in the liraglutide group [（7.2±2.1）,（10.1±2.6）d]（P0.05）.However,the data of C- peptide level show that the β- cell function of patients in the liraglutide group were better recovered than that in the intensive insulin group at the same time [（4.21 ±0.97）,（3.57±0.98）,（7.14±1.12）,（6.56±0.95）,（5.38±1.08）,（4.95±1.02）nmol/L]（all P0.05）.Conclusion Even in the short- term therapy,liraglutide therapy is superior to the intensive insulin therapy in recovering the β- cell function and is propitous to long- term glucose control which provide better security.

关 键 词：2型糖尿病 利拉鲁肽 C-肽 胰岛Β细胞 

分 类 号：R587.1[医药卫生—内分泌]