利拉鲁肽联合诺和锐30对2型糖尿病患者糖代谢指标和胰岛功能及生化指标的影响  

Effects of liraglutide and Novorapid 30 on the glycometabolism, islet function and biochemical indexes of patients with type 2 diabetes mellitus

作　　者：陈英刚[1] 吕春苗[2] 陈海君[3] 汪建明[3] 袁青[4] 吴平[3] 盛棋跃[3] 王姗姗[1] CHEN Ying-gang LV Chun-miao CHEN Hai-jun WANG Jian-ming YUAN Qing WU Ping SHENG Qi-yue WANG Shan-shan(Department of Endocrine, Jinhua Municipal Cental Hospital, Jinhua, Zhefiang Province 321000, China)

机构地区：[1]金华市中心医院内分泌科,浙江省金华321000 [2]金华市中心医院心血管二科 [3]金华市中心医院感染科 [4]金华市中心医院检验科

出　　处：《中国慢性病预防与控制》2016年第9期671-674,共4页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：浙江省医药卫生科技计划项目(2015KYB418)

摘　　要：目的 探讨利拉鲁肽联合诺和锐30对2型糖尿病（T2DM）患者糖代谢指标、胰岛功能及生化指标的影响,为临床诊断治疗提供参考价值。方法 选取2014年5月至2015年5月金华市中心医院收治的148例T2DM患者为研究对象,采用随机数字表法将患者随机分为联合治疗组与对照组,每组74例。对照组给予诺和锐30治疗,联合治疗组在对照组基础上结合利拉鲁肽治疗。两组疗程均为12周。比较两组患者糖代谢指标、胰岛功能及生化指标治疗前后变化及不良反应发生情况,用SPSS 22.0软件对数据进行χ2检验和t检验。结果 联合治疗组治疗后空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化红蛋白（Hb A1C）[分别为（6.49±0.47）、（9.80±1.42）mmol/L和7.01%±0.37%]明显低于对照组[分别为（7.12±0.62）、（11.02±1.78）mmol/L和7.62%±0.49%],差异均有统计学意义（t值分别为6.966、4.609、8.546,P〈0.05）;联合治疗组治疗后胰岛素分泌指数（HOMA-β）高于对照组（分别为81.27±8.95和73.37±7.31）,空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR）低于对照组[分别为（12.15±0.97）m U/L、3.50±0.47和（13.23±1.18）m U/L、4.19±0.56],差异均有统计学意义（t值分别为5.881、6.082和8.119,P〈0.05）;联合治疗组治疗后血清一氧化氮（NO）水平高于对照组[分别为（38.56±5.13）、（34.27±5.70）μmol/L],内皮素-1（ET-1）低于对照组[分别为（51.39±4.31）、（58.91±4.56）ng/L],差异均有统计学意义（P〈0.05）;联合治疗组治疗后血清白细胞介素-6（IL-6）和C反应蛋白（CRP）水平低于对照组[分别为（20.14±2.54）、（22.38±2.31）ng/ml和（1.62±0.35）、（2.10±0.41）ng/ml],差异均有统计学意义（P〈0.05）。两组均未见严重的药物不良反应。结论利拉鲁肽联合诺和锐30可明显改善T2DM患者糖代谢和胰岛功能,且可改善患者血管内皮功能,减轻患者炎症状态。Objective To investigate the effects of liraglutide combined with Novorapid 30 on the glycometabolism, islet function and biochemical indexes of patients with type 2 diabetes mellitus （T2DM）, to provide some reference for clinical diagnosis and treatment. Methods From May 2014 to May 2015, 148 T2DM patients in our hospital served as the subjects. The random number table method was used to divide 148 subjects into study group （74 cases） and control group （74 cases）. The control group was treated with Novorapid 30, the study group was treated with Novorapid 30 plus liraglutide for 12 weeks. After treatment for 12 weeks, the indexes of glycometabolism, islet function, biochemical test and adverse side-effects were compared between two groups. SPSS.22.0 software was used to analyze the data with X2 test and t teat. Results After treatment, FPG（6.49±0.47 mmol/L）, 2 h PG（9.80±1.42 mmol/L）, HbA1c（7.01%±0.37%）, FINS（12.15±0.97 mU/L） and HOMA-IR（3.50±0.47） of study group were significantly lower than those （7.12±0.62 mmol/L, 11.02±1.78 mmol/L,7.62%±0.49%, 13.23 ±1.18 mU/L and 4.19±0.56） of control group （P〈0.05）; but HOMA-[3 （81.27±8.95） of study group was significantly higher than that （73.37±7.31）of control group （P〈0.05）; the serum NO level（38.56±5.13 μmol/L） in the study group was significantly higher than that （34.27±5.70 μmol/L）in the control group, ET-1 level（51.39±4.31 ng/L） in the study group was significantly lower than that （58.91±4.56 ng/L） in the control group （P〈0.05）; the serum IL-6 and CRP levels （20.14±2.54,22.38±2.31 ng/ml） in the study group were significantly lower than those （1.62±0.35,2.10±0.41 ng/ml） in the control group （P〈0.05）. No serious adverse side-effects of medications were found in the two groups. Conclusion The liraglutide combined with Novorapid 30 can significantly improve the glycometabolism and insulin function of T2DM patients, can significantly improve the vascular endoth

关 键 词：糖尿病 2型 利拉鲁肽 诺和锐30 糖代谢 胰岛功能 生化指标 

分 类 号：R587.1[医药卫生—内分泌]