利拉鲁肽与门冬胰岛素30对2型糖尿病轻度认知损伤患者认知功能影响的比较  

Effects of liraglutide versus insulin aspart 30 on cognitive function in patients with type 2 diabetic mild cognitive impairment

作　　者：刘璠[1] 杨爱格[1] 董闪闪[1] 康岩[1] 贾新菊[1] 周慧敏[1] 

机构地区：[1]河北医科大学第一医院内分泌科,河北石家庄050031

出　　处：《中国新药与临床杂志》2017年第11期671-676,共6页Chinese Journal of New Drugs and Clinical Remedies

基　　金：2016年河北省科技计划(指令)项目(16277789D)

摘　　要：目的探讨利拉鲁肽和门冬胰岛素30治疗2型糖尿病轻度认知损伤(MCI)的有效性、安全性及其对认知功能的影响和差异。方法 2型糖尿病MCI患者80例,随机分为两组,每组40例,胰岛素组维持原门冬胰岛素30治疗,利拉鲁肽组改为利拉鲁肽治疗,疗程均为48周。治疗前和治疗12、24、36、48周末测定患者血糖、血脂和血压水平,计算体重指数(BMI),进行蒙特利尔认知评估(MoCA)量表评分,并记录血糖达标[糖化血红蛋白(HbA_(1c))≤7%]、低血糖及痴呆发生情况。结果胰岛素组和利拉鲁肽组各完成39例和38例。治疗24、36周末,利拉鲁肽组三酰甘油水平显著低于胰岛素组(P<0.01),48周末HbA_(1c)水平低于胰岛素组(P<0.05),Mo CA量表评分高于胰岛素组(P<0.05)。胰岛素组和利拉鲁肽组血糖达标率分别为77%(30/39)和84%(32/38),痴呆发生率分别为5%(2/39)和0,差异均无显著意义(P>0.05);低血糖发生率分别为64%(25/39)和24%(9/38),利拉鲁肽组低于胰岛素组(P<0.01)。结论与门冬胰岛素30相比,利拉鲁肽治疗2型糖尿病MCI患者,可更好地控制HbA_(1c),低血糖发生率更低,并可改善患者认知功能。AIM To explore the efficacy and safety of liraglutide and insulin aspart 30 and compare their effects on the cognitive function in patients with type 2 diabetic mild cognitive impairment. METHODS Eighty patients with type 2 diabetic mild cognitive impairment were collected and randomly divided into insulin group（n = 40） and liraglutide group（n = 40）. During the 48-week treatment period, patients in the liraglutide group transferred to liraglutide from insulin aspart 30 injection, and patients in the insulin group continued the insulin aspart 30 injection treatment. At the end of week 0, 12, 24, 36 and 48 of the treatment, HbA1c, FPG,2hPG, TG, TC, SBP and DBP were measured, and body mass index calculated and score of MoCA assessed.All hypoglycemic events during the trial, the percentage of patients achieving HbA1c target of ≤ 7% and the incidence of dementia were recorded. RESULTS There were 39 patients in the insulin group and 38 patients in the liraglutide group completed the study. Compared with the insulin group, TG in the liraglutide group was significantly reduced at the end of week 24 and 36（P 〈 0.01）, while HbA1c was significantly lower（P 〈 0.05）and score of MoCA higher（P 〈 0.05） than the insulin group at the end of week 48. There were no significant differences in the percentage of patients achieving HbA1c target of ≤7%（77%（30/39） vs. 84%（32/38）, P 〉0.05） and the incidence of dementia（ 5%（ 2/39 vs. 0）, P 〉 0.05） between insulin group and liraglutide group, while the incidence of hypoglycemia in the liraglutide group（24%（9/38）） was significantly lower than the insulin group（ 64%（ 25/39）, P 〈 0.01）. CONCLUSION Compared with insulin aspart 30, liraglutide treatment of patients with type 2 diabetic mild cognitive impairment can control HbA1c better, lower incidence of hypoglycemia, and can improve cognitive function of patients.

关 键 词：糖尿病 2型 利拉鲁肽 门冬胰岛素30 轻度认知损伤 

分 类 号：R587.1[医药卫生—内分泌] R977.15[医药卫生—内科学]