利拉鲁肽联合短期胰岛素强化治疗初诊肥胖2型糖尿病患者疗效及对炎性因子的影响  

Effect of liraglutide combined with short-term intensive insulin therapy on newly diagnosed obese type 2 diabetes mellitus and its influence on inflammatory factors

作　　者：张洁[1] 董闪闪[1] 陈志花[1] 贾新菊[1] 吕晓静[1] 周慧敏[1] Zhang Jie;Dong Shanshan;Chen Zhihua;Jia Xinju;Lyu Xiaojing;Zhou Huimin(Department of Endocrinology, The First Hospital of Hebei Medical University, Hebei Province,Shijiazhuang 050031, China)

机构地区：[1]河北医科大学第一医院内分泌科,石家庄050031

出　　处：《疑难病杂志》2020年第8期769-773,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：河北省卫健委重点科技研究计划项目(20170501)。

摘　　要：目的观察利拉鲁肽联合短期胰岛素强化治疗在初诊肥胖2型糖尿病患者中的降糖疗效,以及对炎性因子的影响。方法选取2017年7月—2018年6月在河北医科大学第一医院内分泌科初诊肥胖2型糖尿病患者80例,随机数字表法分为2组各40例,观察组在胰岛素强化治疗联合二甲双胍的基础上联用利拉鲁肽,对照组予以胰岛素强化治疗联合二甲双胍,治疗4周后,比较2组治疗前后BMI、腰围、内脏脂肪面积、血糖、血糖波动、血糖达标时间、胰岛素用量以及肿瘤坏死因子(TNF-α)、白介素1β(IL-1β)、白介素6(IL-6)等指标变化。结果与对照组治疗后比较,观察组BMI、腰围、内脏脂肪面积明显减少(t/P=2.710/0.001、3.560/0.001、3.561/0.001);空腹血糖(FPG)、餐后2 h血糖(2 hPG)、日间血糖平均绝对差(MODD)、平均血糖波动幅度(MAGE)均明显减低(t/P=3.564/0.001、3.316/0.002、4.765/0.000、3.559/0.001);血糖达标时间缩短,胰岛素用量减少(t/P=4.899/0.000、4.825/0.000);炎性因子TNF-α、IL-1β、IL-6显著降低(t/P=2.468/0.024、2.493/0.012、2.688/0.008)。结论初诊肥胖2型糖尿病患者在胰岛素强化治疗的基础上联用利拉鲁肽,可促使血糖尽快达标,减少胰岛素用量,降低炎性因子水平。Objective To observe the hypoglycemic effect of liraglutide combined with short-term intensive insulin therapy in newly diagnosed obese patients with type 2 diabetes mellitus and its influence on inflammatory factors.Methods From July 2017 to June 2018,80 newly diagnosed obese patients with type 2 diabetes in the Department of Endocrinology,the first Hospital of Hebei Medical University were selected.The patients were randomly divided into two groups with 40 cases in each group.The observation group was given liraglutide on the basis of intensive insulin therapy combined with metformin.The control group was given intensive insulin therapy combined with metformin.After 4 weeks of treatment,the changes of BMI,waist circumference,visceral fat area,blood glucose,blood glucose fluctuation,blood glucose reaching the standard time,insulin dosage,tumor necrosis factor(TNF-α),interleukin(IL-1β,IL-6)were compared between the two groups before and after treatment.Results After treatment,compared with the control group,BMI,waist circumference,visceral fat area of the observation group were significantly reduced(t/P=2.710/0.001,3.560/0.001,3.561/0.001),fasting blood glucose(FPG),postprandial 2-hour blood glucose 2 hPG,MODD and MAGE were significantly decreased(t/P=3.564/0.001,3.316/0.002,4.765/0.000,3.559/0.001),the time of blood glucose reaching the standard was shortened,the dosage of insulin was decreased(t/P=4.899/0.000,4.825/0.000),and the inflammatory factors TNF-α,IL-1βand IL-6 were significantly decreased(t/P=2.468/0.024,2.493/0.012,2.688/0.008).Conclusions The combination of liraglutide and intensive insulin therapy in newly diagnosed obese patients with type 2 diabetes can promote blood glucose to reach the standard as soon as possible,reduce the dosage of insulin and reduce the level of inflammatory factors.

关 键 词：利拉鲁肽 胰岛素强化治疗 短期 糖尿病 2型 肥胖 炎性因子 

分 类 号：R58[医药卫生—内分泌]