利拉鲁肽联合恩格列净治疗肥胖2型糖尿病患者的疗效观察  

Efficacy of liraglutide combined with enpagliflozin in the treatment of obesity complicated by type 2 diabetes mellitus

作　　者：杨晓瑜[1] 鲁扬[1] 赵敏霞[1] 马俊 孔令妍 Yang Xiaoyu;Lu Yang;Zhao Minxia;Ma Jun;Kong Linyan(Department of Endocrinology,Yuyao People's Hospital,Yuyao 315400,Zhejiang Province,China)

机构地区：[1]余姚市人民医院内分泌科,315400

出　　处：《中国基层医药》2021年第12期1798-1802,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨利拉鲁肽联合恩格列净治疗肥胖2型糖尿病患者的疗效。方法选取2018年10月至2019年10月在余姚市人民医院就诊的肥胖2型糖尿病患者160例作为研究对象。采用随机数字表法分两组各80例。对照组采用瑞格列奈片联合地特胰岛素及二甲双胍治疗,观察组采用利拉鲁肽联合恩格列净及二甲双胍治疗。治疗3个月后比较患者空腹血糖(FPG)、糖化血红蛋白(HbAlc)、餐后2 h血糖(2hPG)、体质量指数(BMI)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、白细胞介素6(IL-6)及瘦素、脂联素、丝氨酸蛋白酶抑制物(vaspin)变化,统计患者不良反应发生情况。结果治疗后,两组患者的FPG、HbAlc、2hPG、BMI均降低,且观察组[(7.89±1.02)mmol/L、(8.10±1.25)%、(11.10±1.59)mmol/L、(23.18±2.19)kg/m2]均明显低于对照组[(9.88±1.27)mmol/L、(11.20±1.85)%、(13.67±2.01)mmol/L、(27.80±2.51)kg/m2],差异均有统计学意义(t1=10.927,t2=12.418,t3=8.969,t4=12.405,均P<0.001);治疗后,两组TNF-α、CRP、IL-6均降低,且观察组[(51.19±3.19)pg/L、(2.14±0.31)mg/L、(4.07±0.67)pg/L]均明显低于对照组[(62.18±4.10)pg/L、(3.66±0.58)mg/L、(5.96±0.81)pg/L],差异均有统计学意义(t1=18.922,t2=20.672,t3=8.969,均P<0.001);治疗后,两组瘦素、vaspin均降低,且观察组[(5.48±0.94)μg/L、(1.62±0.37)μg/L]均低于对照组[(6.59±0.82)μg/L、(1.99±0.52)μg/L],而脂联素升高,观察组[(7.13±1.52)mg/L]高于对照组[(5.12±0.85)mg/L],差异均有统计学意义t1=7.959,t2=10.323,t3=5.185,均P<0.001);两组不良反应发生率比较,差异无统计学意义(χ^(2)=0.313,P>0.05)。结论利拉鲁肽联合恩格列净治疗肥胖2型糖尿病患者疗效显著,可有效降低患者血糖、体质量,减轻炎性反应,进一步调节血清vaspin、瘦素及脂联素水平,安全性高,可在临床推广使用。Objective To investigate the efficacy of liraglutide combined with enpagliflozin in the treatment of obesity complicated by type 2 diabetes mellitus.Methods A total of 160 obesity patients with type 2 diabetes mellitus who received treatment in Yuyao People's Hospital,China between October 2018 and October 2019 were included in this study.They were randomly assigned to receive repaglinide,insulin detemir and metformin in combination(control group,n=80)or liraglutide,enpagliflozin and metformin in combination(treatment group,n=80).After 3 months of treatment,fasting blood glucose,glycosylated hemoglobin,2-hour postprandial blood glucose,body mass index,tumor necrosis factor-alpha,C-reactive protein,interleukin-6,leptin,adiponectin,and vaspin as well as the incidence of adverse reactions were compared between the control and treatment groups.Results After treatment,fasting blood glucose,glycosylated hemoglobin,2-hour postprandial blood glucose and body mass index were reduced in each group.They were(7.89±1.02)mmol/L,(8.10±1.25)%,(11.10±1.59)mmol/L,(23.18±2.19)kg/m2,respectively in the observation group,which were significantly lower than those in the control group[(9.88±1.27)mmol/L,(11.20±1.85)%,(13.67±2.01)mmol/L,(27.80±2.51)kg/m2,t1=10.927,t2=12.418,t3=8.969,t4=12.405,all P<0.001).After treatment,tumor necrosis factor-alpha,C-reactive protein and interleukin-6 levels were reduced in each group.Their levels in the observation group were[(51.19±3.19)pg/L,(2.14±0.31)mg/L,(4.07±0.67)pg/L,respectively,which were significantly lower than those in the control group[(62.18±4.10)pg/L,(3.66±0.58)mg/L,(5.96±0.81)pg/L,t1=18.922,t2=20.672,t3=8.969,all P<0.001).After treatment,leptin and vaspin levels were reduced in each group,and their values in the observation group were(5.48±0.94)μg/L,(1.62±0.37)μg/L,respectively,which were significantly lower than those in the control group[(6.59±0.82)μg/L,(1.99±0.52)μg/L,t1=7.959,t2=10.323,both P<0.001].Adiponectin level increased in each group,and it was significan

关 键 词：糖尿病 2型 肥胖症 血糖 炎症趋化因子类 脂联素 瘦素 药物相关性副作用和不良反应 利拉鲁肽 恩格列净 

分 类 号：R587.1[医药卫生—内分泌]