新诊2型糖尿病患者短期强化降糖序贯GLP-1的随访研究  

Follow-up study on short-term intensive glycemic control sequential therapy of GLP-1 in newly diagnosed type 2 diabetic patients

作　　者：温滨红 王晓晨 赵璐 杨硕 贺薇 胡晓娜 徐嘉妤 

机构地区：[1]中国医科大学人民医院辽宁省人民医院,沈阳110016

出　　处：《实用药物与临床》2018年第2期153-156,共4页Practical Pharmacy and Clinical Remedies

基　　金：辽宁省省直医院改革重点临床科室诊疗能力建设项目-青年项目(LNCCC-D35-2015);辽宁省科技厅面上项目(2015020658)

摘　　要：目的探究短期强化降糖序贯GLP-1治疗模式对新诊2型糖尿病(T2DM)患者的远期疗效。方法通过对50例新诊T2DM患者短期强化降糖,使血糖达标(FPG<6.1 mmol/L,2hPG<8.0 mmol/L)后,给予饮食运动或利拉鲁肽干预,随访1年,比较干预前后血糖缓解率、病情缓解时间及胰岛B细胞第一时相分泌的变化。结果饮食运动组血糖缓解率为52.38%,病情缓解时间为(72.30±52.23)d,干预前、随访1年后的胰岛B细胞第一时相分泌曲线下面积AUC_(Ins0~10 min)为(274.11±134.83)、(297.87±123.38)mU·min/L(P>0.05),AUCCp0~10 min为(21.45±7.66)、(23.21±7.84)ng·min/mL(P<0.05)。利拉鲁肽组血糖缓解率为56.00%,病情缓解时间为(71.91±47.12)d,干预前、随访1年后的胰岛B细胞第一时相分泌曲线下面积AUC_(Ins0~10 min)为(299.00±132.16)、(317.22±107.91)mU·min/L(P>0.05),AUCCp0~10 min为(21.87±7.76)、(23.65±7.02)ng·min/mL(P<0.05)。结论GLP-1干预可提高新诊T2DM患者的血糖缓解率,延长病情缓解时间,改善胰岛B细胞第一时相分泌功能,但这种效应随着GLP-1的停用而消退。Objective To investigate the long-term therapeutic effects of short-term intensive glycemic control sequential therapy of GLP-1 on patients newly diagnosed with type 2 diabetes mellitus（ T2 DM）. Methods Fifty newly diagnosed T2 DM patients were treated with short-term intensive glycemic control in order to reach the standard level（ FPG 6. 1 mmol/L,2 hPG 8. 0 mmol/L）,and then they were given diet and exercise（ control group） or liraglutide（ liraglutide group） for intervention. One-year follow-up was carried out. The rate and time of glucose remission and the first phase secretion of pancreatic β-cell function were compared before and after intervention. Results The glucose remission rate was 52. 38% in control group; the duration of relief was（ 72. 30 ± 52. 23） d; the first phase secretion of isletβ-cell function area under the curve intervention and after 1-year follow-up was ： AUC（Ins0-10 min）（ 274. 11 ± 134. 83）mU·min/L vs.（ 297. 87 ± 123. 38） mU·min/L（ P〈0. 05）,AUCCp0 - 10 min（ 21. 45 ± 7. 66） ng·min/mL vs.（ 23. 21 ±7. 84） ng·min/mL（ P〈0. 05）. The glucose remission rate was 56. 00% in liraglutide group; the duration of relief was（ 71. 91 ± 47. 12） d; the first phase secretion of pancreatic β-cell function area under the curve before intervention and after 1-year follow-up was： AUC（Ins0-10 min）（ 299. 00 ± 132. 16） mU·min/L vs.（ 317. 22 ± 107. 91） mU·min/L（ P〈0. 05）,AUC（Cp0 - 10 min）（ 21. 87 ± 7. 76） ng·min/mL vs.（ 23. 65 ± 7. 02） ng·min/mL（ P〈0. 05）. Conclusion GLP-1 can increase the glucose remission rate and prolong the time of symptom relief,and improve the first phase secretion of pancreatic β-cell function,but the effects disappear gradually with the drug withdrawal.

关 键 词：胰升血糖素样肽1 2型糖尿病 静脉葡萄糖耐量试验 胰岛B细胞 

分 类 号：R587.1[医药卫生—内分泌]