动态血糖监测利拉鲁肽与艾塞那肽对超重/肥胖2型糖尿病患者疗效的观察  

To observe the efficacy between Liraglutide and Exenatide on 24 h glycemic changes with continuous glucose monitoring in overweight and obese patients with type 2 diabetes mellitus

作　　者：范晓霞[1] 姚勇利[1] 胡耀嘉 刘学良 王淑琼[1] 谢延玲[1] 范培云[1] 罗玮[1] 宋康[1] 魏兰[1] 赵玲玲[1] 林丽君[1] 王贝贝[1] FAN Xiaoxia,YAO Yongli,HU Yaojia, et al.(Department of Diabetes, The People＇s Hospital of Qinghai Provinice. Xi＇ning 810007 ,China)

机构地区：[1]青海省人民医院糖尿病科,西宁810007 [2]兰州大学第一临床医学院 [3]青海省食品药品监督管理局

出　　处：《中国糖尿病杂志》2018年第8期637-639,共3页Chinese Journal of Diabetes

基　　金：吴阶平医学基金会资助项目(320.6750.15199);青海省卫生计生系统科研课题(2017-WJZDX-18)

摘　　要：目的使用动态血糖监测利拉鲁肽与艾塞那肽对超重/肥胖T2DM患者治疗疗效的比较。方法收集2014年1月至2016年4月于青海省人民医院糖尿病科住院的BMI>28kg/m2的T2DM患者80例,按随机数字表法分为利拉鲁肽组42例和艾塞那肽组38例,两组均联合二甲双胍治疗24周。检测FPG、2hPG、HbA1c、体重、血压、给药前后24h平均血糖(MBG)、24h血糖标准差(SDBG)、24h血糖波动范围,平均血糖波动幅度(MAGE)及高血糖比例,并观察不良反应等。记录用药期间低血糖发生情况和其他不良反应。结果治疗前后两组血糖、HbA1c、血压、BMI、MBG、24h血糖波动范围、MAGE及高血糖比例下降(P<0.05)。治疗后利拉鲁肽组FPG、HbA1c优于艾塞那肽组,而艾塞那肽组2hPG优于利拉鲁肽组(P<0.05)。结论对超重/肥胖的T2DM患者,利拉鲁肽与艾塞那肽均能有效控制血糖水平及血糖波动,安全性好;艾塞那肽能更有效降低患者2hPG水平;利拉鲁肽降低FPG、HbA1c水平更为明显。Objective To observe the efficacy of Liraglutide and Exenatide on 24 hglycemic changes with continuous glucose monitoring in overweight and obese patients with type 2 diabetes mellitus（T2 DM）. Methods 80 T2 DM patients with poor glycemic control admitted in our department from January 2014 to April 2016 were randomly divided into two groups named liraglutide group（n=42）and the Exenatide group（n=38）.Both groups were combined with Metformin therapy for 24 weeks.The indicators included the change of FPG,2 hPG,HbA1c,weight,waist circumference,blood pressure,the average 24 h blood glucose level（MBG）,SD of the 24 hblood glucose level（SDBG）,24 hglycemic fluctuation range,mean amplitude of glycemic excursions（MAGE）and the rate of high glycemic state. Results After treatment,the levels of FPG,2 hPG,HbA1c,BMI,MBG,blood glucose fluctuation range and MAGE in Liraglutide group decreased.The levels of FPG,2 hPG,HbA1c,BMI,MBG,blood glucose fluctuation range and MAGE in Exenatide group decreased.Liraglutide group had better FPG and HbA1c control than Exenatide group.The improvement of 2 hPG in Exenatide group was better than that of Liraglutide group. Conclusion Both Liraglutide and Exenatide can effectively control blood glucose and reduce glycemic fluctuation.Liraglutide may be more beneficial to the patients accompanied with obesity and hypertension than Exenatide.Exenatide may be more beneficial to 2 hPG.

关 键 词：利拉鲁肽 艾塞那肽 超重 肥胖 糖尿病 2型 动态血糖监测 

分 类 号：R587.1[医药卫生—内分泌]