利拉鲁肽联合甘精胰岛素治疗对新诊断2型糖尿病患者长期临床缓解的疗效观察  

Effect of Liraglutide combine with insulin glargine in long-term clinical remission in newly diagnosed type 2 diabetes mellitus

作　　者：卓雅芬[1] 孙志纯[1] 洪真真 黄文森 张翼[1] ZHUO Yafen;SUN Zhichun;HONG Zhenzhen(Department of Endocrinology,Quanzhou First Hospital of Fujian Province,Quanzhou 362300,China)

机构地区：[1]福建省泉州市第一医院内分泌科,362300

出　　处：《中国糖尿病杂志》2021年第10期733-737,共5页Chinese Journal of Diabetes

基　　金：福建省自然科学基金(2018J01371)。

摘　　要：目的观察新诊断T2DM患者经利拉鲁肽联合甘精胰岛素短期强化治疗后对血糖控制、胰岛β细胞功能改善及维持长期临床缓解的疗效。方法对117例新诊断T2DM患者进行1个月利拉鲁肽联合甘精胰岛素强化治疗并进行纵向随访。比较治疗前后BMI、HbA1c、FPG、2 hPG、FC-P、HOMA-IR(C-P)、HOMA-β(C-P)。维持1年血糖正常患者为缓解组,复发血糖异常患者为非缓解组,比较两组治疗后相关指标。结果利拉鲁肽联合甘精胰岛素治疗结束时FC-P、lgHOMA-β(C-P)水平较基线升高(P<0.05),临床缓解率达42.74%。缓解组治疗1年后BMI、FPG、2 hPG、HbA1c、lgHOMA-IR(C-P)水平均低于未缓解组(P<0.05),FC-P、lgHOMA-β(C-P)高于未缓解组(P<0.05)。Cox模型显示,新诊断时HbA1c越低、治疗期间体重降低越大,临床缓解越佳[(RR(95%CI)1.434(1.155~1.781),P=0.001;1.475(1.294~1.683),P=0.000]。结论利拉鲁肽联合甘精胰岛素治疗有利于改善新诊断T2DM患者强化治疗后胰岛β细胞功能,维持血糖长期达标,延长临床缓解期。HbA1c越低、体重减轻更多的新诊断T2DM患者临床缓解更佳。Objective To investigate the effect of short-term intensive therapy of Liraglutide combined with insulin glargine on blood glucose control,improvement of isletβcell function and maintenance of long-term clinical remission in patients with newly diagnosed type 2 diabetes mellitus(T2DM).Methods A total of 117 patients with newly diagnosed T2DM were enrolled in this study and treated with one-month intensive therapy of liraglutide combined with insulin glargine.All the patients were followed up longitudinally.BMI, HbA_(1)c,FPG,2 h postprandial blood glucose(2 h PG),FC-P,HOMA-IR(C-P)and HOMA-β(C-P)were compared before and after treatment.The patients who maintained their blood glucose control for one year were the remission group and the patients who relapsed were the non-remission group.The relevant indicators were compared after treatment between the two groups.Results At the end of Liraglutide combined with insulin glargine treatment,FC-P and lg HOMA-β(C-P)levels were higher than baseline(P<0.05),and the clinical response rate reached 42.74%.After one year follw up,the levels of BMI,FPG,2 h PG, HbA_(1)c and lg HOMA-IR(C-P)were lower in the remission group than in the non-remission group(P<0.05)and the levels of FC-P and lg HOMA-β(C-P)were higher in the remission group than in the non-remission group(P<0.05).Cox model showed that the lower HbA_(1)c value at baseline and the greater weight loss during treatment had a positive effect on clinical remission(RR 1.434,95%CI 1.155~1.781,P=0.001;RR1.475,95%CI 1.294~1.683,P=0.000).Conclusion The combination of Liraglutide and insulin glargine is beneficial in improving the function of isletβcells,maintaining the long-term blood glucose standard and prolonging the clinical remission period after intensive treatment in newly diagnosed T2DM.Clinical remission is more common in patients with shorter disease duration and greater weight loss.

关 键 词：糖尿病 2型 利拉鲁肽 甘精胰岛素 临床缓解 

分 类 号：R587.1[医药卫生—内分泌]