艾塞那肽对血糖控制不佳的肥胖糖尿病患者疗效分析  

Study on the efficacy of exenatide on type 2 diabetes patients with obese and poor glycemic control

作　　者：蒋艳敏[1] 徐湘[1] 卜瑞芳[1] 朱圣炜[1] 陈诚[1] 

机构地区：[1]南京医科大学附属无锡人民医院内分泌科,江苏无锡214023

出　　处：《临床与病理杂志》2016年第5期574-580,共7页Journal of Clinical and Pathological Research

摘　　要：目的:观察血糖控制不佳的肥胖2型糖尿病(type 2 diabetes mellitus,T2DM)患者加用艾塞那肽后的疗效。方法:选取研究对象60例(退出3例,实际完成57例),根据不同体重指数(BMI)分为A组(25kg/m2≤BMI<30kg/m^2)23例,B组(30kg/m2≤BMI<35kg/m^2)27例,C组(35kg/m2≤BMI<40kg/m2)7例,连续给予艾塞那肽治疗12周,比较治疗前后3组患者的临床疗效及血清指标变化。结果:随访结束后,所有患者平均空腹血糖(fastingbloodglucose,FBG)水平、HbA1c、体重和BMI、血脂(TC、TG、LDL)等较基线有明显下降(P<0.05);所有患者平均空腹胰岛素(fastingserum in sulin,FINS)水平较治疗前有所升高(P>0.05),所有患者HOMA-IR较治疗前明显降低(P均<0.05),HOMA-β较治疗前无显著变化(P>0.05)。3组间比较显示,各组FBG下降幅度C组>B组>A组(P>0.05);HbA1c下降幅度水平C组>A组(P<0.05);体重减轻幅度和BMI的下降幅度依次为C组>B组>A组(P均<0.05)。结论:艾塞那肽可以有效控制血糖控制不佳的肥胖T2DM患者的FBG、HbA1c,改善血脂水平和胰岛功能,减轻体重和BMI。其中,艾塞那肽对FBG、HbA1c、体重、BMI的疗效,在BMI较高组中疗效更显著。Objective： To study the efficacy of exenatide on poor blood glucose control of the type 2 diabetes patients with obese. Methods： Sixty type 2 diabetes cases（57 cases completed） were selected and divided into three groups based on BMI： group A（25 kg/m^2 ≤ BMI 30 kg/m^2）（n=23）, group B（30 kg/m^2≤ BMI 35 kg/m^2）（n=27）, group C（35 kg/m^2 ≤ BMI 40 kg/m^2）（n=7）. All the cases were treated with exenatide for 12 weeks, then compared the clinical efficacy and the change of serum indexes of the three groups before and after treatment. Results： By the end of follow-up, the average level of FBG, Hb A1 c, BMI, body weight and blood lipid（TC, TG, LDL） of all patients decreased significantly compared to the baseline（P〈0.05）. The average level of FINS increased（P〈0.05）. The HOMA-IR of patients was significantly lower than those before treatment（P〈0.05）, no significant difference shown in HOMA-IR. Comparison among the three groups showed that the range of FBG decreased was group C group B group A（P〈0.05）, the range of Hb A1 c decreased was group C group A（P〈0.05）, the range of BMI decreased and weight loss was group C group B group A（P〈0.05）. Conclusion： Exenatide can effectively control the FBG, Hb A1 c, BMI, and body weight. It also can improve the blood lipid level and islet function.

关 键 词：艾塞那肽 体重指数 肥胖 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]