甘精胰岛素联合利拉鲁肽治疗2型糖尿病临床效果观察  

Clinical Study on the Combination of Insulin Glargine and Liraglutide in the Treatment of Type 2 Diabetes

作　　者：王芳[1] 赵静[1] 王梦莹 李庆凤 WANG Fang;ZHAO Jing;WANG Meng-ying;LI Qing-feng(Department of Endocrinology,Suzhou Hospital Affiliated to Anhui Medical University Suzhou Municipal Hospital,Suzhou,Anhui 234000,China)

机构地区：[1]安徽医科大学附属宿州医院、宿州市立医院内分泌科,安徽宿州234000

出　　处：《临床误诊误治》2023年第2期123-127,共5页Clinical Misdiagnosis & Mistherapy

基　　金：安徽省重点研究与开发计划(S202004j07020052)。

摘　　要：目的探讨甘精胰岛素联合利拉鲁肽治疗2型糖尿病(T2DM)的效果及安全性。方法回顾性分析2019年10月-2021年2月收治的T2DM 80例,根据治疗方案分为观察组和对照组,每组40例。对照组予以甘精胰岛素治疗,观察组予以甘精胰岛素联合利拉鲁肽治疗。比较2组治疗前后血糖相关指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(HbA1c)]、血脂[低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、总胆固醇(TC)]水平、胰岛功能[胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能指数(HOMA-β)]、炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、淀粉样蛋白A(SAA)]、外周血磷脂酰肌醇激酶(PI3K)/蛋白激酶B(Akt)信号通路相关蛋白表达水平,统计2组不良反应发生情况。结果治疗8、16周后,观察组HOMA-β高于对照组,HOMA-IR、FPG、2 h PG、HbA1c、TG、LDL-C、TC水平低于对照组(P<0.05,P<0.01)。治疗8、16周后,观察组IL-6、SAA、TNF-α、PI3K、Akt低于对照组(P<0.05,P<0.01)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论甘精胰岛素联合利拉鲁肽治疗T2DM具有一定安全性,有助于改善患者胰岛功能,调控血糖、血脂水平,其机制可能与微炎症状态及外周血PI3K/Akt信号通路改善有关。Objective To investigate the efficacy and safety of Insulin Glargine combined with Liraglutide in the treatment of type 2 diabetes mellitus(T2DM).Methods Eighty cases of T2DM admitted from October 2019 to February 2021 were retrospectively analyzed and divided into observation group(n=40)and control group(n=40)according to treatment regimen.The control group was treated with Insulin Glargine,and the observation group was treated with Insulin Glargine combined with Liraglutide.Blood glucose related indexes[fasting plasma glucose(FPG),2 h postprandial blood glucose(2 h PG)and glycosylated hemoglobin(HbA1c)],levels of blood lipid[low density lipoprotein cholesterol(LDL-C),triglyceride(TG),total cholesterol(TC)],islet function[insulin resistance index(HOMA-IR)and isletβcell function index(HOMA-β)],inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),amyloid A(SAA)],and expression levels and safety of proteins related to peripheral blood phosphatidylinositol kinase(PI3K)/protein kinase B(Akt)signaling pathways before and after treatment were compared between the two groups.The incidence of adverse reactions was recorded.Results At 8 and 16 weeks after treatment,HOMA-βin the observation group was higher than that in the control group,while HOMA-IR,FPG,2 h PG,HbA1c,TG,LDL-C and TC levels were lower than those in the control group(P<0.05,P<0.01).At 8 and 16 weeks after treatment,IL-6,SAA,TNF-α,PI3K and Akt in the observation group were lower than those in the control group(P<0.05,P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Insulin Glargine combined with Liraglutide in the treatment of T2DM has certain safety,which can help to improve the pancreatic function of patients and regulate blood glucose and lipid levels.The mechanism may be related to the microinflammatory state and the improvement of PI3K/Akt signaling pathway in peripheral blood.

关 键 词：糖尿病 2型 利拉鲁肽 甘精胰岛素 血糖 低密度脂蛋白胆固醇 白细胞介素6 血清淀粉样蛋白A 

分 类 号：R587.1[医药卫生—内分泌]