利拉鲁肽联合胰岛素注射液治疗2型糖尿病患者的临床研究  

Clinical trial of liraglutide combined with insulin injection in the treatment of patients with type 2 diabetes mellitus

作　　者：赵正历[1] 冯玉俊 耿建林[1] 谷巍[1] 张雪坤[1] ZHAO Zheng-li;FENG Yu-jun;GENG Jian-lin;GU Wei;ZHANG Xue-kun(Department of Endocrinology,Harryson International Peace Hospital,Hengshui 105300,Hebei Province,China;Department of Nuclear Medicine,Hengshui People’s Hospital,Harryson International Peace Hospital,Hengshui 105300,Hebei Province,China)

机构地区：[1]衡水市人民医院、哈励逊国际和平医院内分泌科,河北衡水105300 [2]衡水市人民医院、哈励逊国际和平医院核医学科,河北衡水105300

出　　处：《中国临床药理学杂志》2020年第18期2765-2768,共4页The Chinese Journal of Clinical Pharmacology

基　　金：河北省卫计委医学科学重点科研基金资助项目(20171214);衡水市科技计划基金资助项目(2018014024Z)。

摘　　要：目的研究利拉鲁肽联合胰岛素注射液治疗对2型糖尿病患者的内皮素-1、瘦素和胰岛素抵抗的改善作用。方法按照治疗方法将2型糖尿病患者随机分为对照组(20例)和试验组(40例)。对照组患者接受格列美脲联合胰岛素注射液治疗,口服格列美脲每次2 mg,每天1次,根据血糖变化进行调整;试验组患者腹部注射利拉鲁肽(0.6 mg·d^-1)联合皮下注射胰岛素(0.5 u·kg^-1),并根据血糖变化进行调整,均连续治疗12周。以酶联免疫吸附法测定2组患者治疗前后的内皮素-1、瘦素、胰岛素抵抗和血脂水平。结果治疗后,对照组和试验组的三酰甘油(TG)水平分别为(2.18±0.65)和(1.55±0.71)mmol·L^-1;这2组的总胆固醇(TC)水平分别为(4.43±0.92)和(2.87±0.93)mmol·L^-1;这2组的低密度脂蛋白胆固醇(LDL-C)水平分别为(3.07±0.79)和(2.12±0.58)mmol·L^-1;这2组的内皮素水平分别为(57.89±12.65)和(50.11±16.76)pg·mL^-1;这2组的瘦素水平分别为(4.43±1.87)和(2.43±0.88)pg·mL^-1;这2组的空腹血糖(FPG)水平分别为(7.17±1.08)和(6.12±1.32)mmol·L^-1,这2组的餐后2 h血糖(2 hPBG)水平分别为(9.01±1.56)和(7.81±3.76)mmol·L^-1;这2组的稳态模型评估(HOMA-IR)水平分别为3.78±0.90和2.89±0.83。上述指标:2组间比较差异均有统计学意义(均P<0.05)。结论利拉鲁肽联合胰岛素治疗对2型糖尿病患者内皮素-1、瘦素及胰岛素抵抗有明显的改善作用。Objective To study the effects of liraglutide combined with intensive insulin therapy on endothelin-leptin system and insulin resistance in type 2 diabetic patients.Methods Type 2 diabetes patients were randomly divided into two groups according to the treatment method:Control group(20 cases)and treatment group(40 cases).The patients in the control group received intensive treatment of glimepiride(2 mg,qd,po)combined with insulin(0.5 u·kg^-1,im),once a day,adjust according to the change of blood glucose;the patients in the treatment group received liraglutide(0.6 mg,qd,im)combined with insulin(0.5 u·kg^-1,im)intensive treatment;and adjust according to the change of blood sugar,continuous treatment for 12 weeks.The levels of endothelin,leptin,insulin resistance and lipid in the two groups before and after treatment were determined by enzyme linked immunosorbent assay.Results The triglyceride(TG)in control group and treatment group were(2.18±0.65)and(1.55±0.71)mmol·L^-1;total cholesterol(TC)in the two groups were(4.43±0.92)and(2.87±0.93)mmol·L^-1;low density lipoprotein cholesterol(LDL-C)in the two groups were(3.07±0.79)and(2.12±0.58)mmol·L^-1;endothelin in the two groups were(57.89±12.65)and(50.11±16.76)pg·mL^-1;leptin in the two groups were(4.43±1.87)and(2.43±0.88)pg·mL^-1;fasting plasma glucose(FPG)in the two groups were(7.17±1.08)and(6.12±1.32)mmol·L^-1;2-hour postprandial blood glucose(2 h PBG)in the two groups were(9.01±1.56)and(7.81±3.76)mmol·L^-1;homeostasis model assessment(HOMA-IR)in the two groups were 3.78±0.90 and 2.89±0.83.Comparison between treatment group and control group,the difference of the factors were significant(all P<0.05).Conclusion Liraglutide combined with intensive insulin therapy can significantly improve the endothelin-leptin system and insulin resistance in type 2 diabetic patients.

关 键 词：利拉鲁肽 胰岛素注射液 2型糖尿病 内皮素 瘦素 胰岛素抵抗 

分 类 号：R977.15[医药卫生—药品]