利拉鲁肽、沙格列汀及甘精胰岛素对血糖控制不佳2型糖尿病的疗效  

Efficacy of liraglutide,saxagliptin and insulin glargine on type 2 diabetes mellitus of poor blood glucose control

作　　者：张新乐[1] 敖文[2] 刘惠双[3] ZHANG Xinle;AO Wen;LIU Huishuang(Department of Pharmacy,the 7th People’s Hospital of Zhengzhou,Zhengzhou 450000,China;Department of Endocrinology and Gerontology,the 7th People’s Hospital of Zhengzhou,Zhengzhou 450000,China;Department of Clinical Nutrition,the 7th People’s Hospital of Zhengzhou,Zhengzhou 450000,China)

机构地区：[1]郑州市第七人民医院药学部,郑州450000 [2]郑州市第七人民医院内分泌老年病科,郑州450000 [3]郑州市第七人民医院临床营养科,郑州450000

出　　处：《西北药学杂志》2023年第4期146-152,共7页Northwest Pharmaceutical Journal

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20191124)。

摘　　要：目的比较利拉鲁肽、沙格列汀与甘精胰岛素对血糖控制不佳2型糖尿病(type 2 diabetes mellitus,T2DM)患者的治疗效果及安全性。方法选取血糖控制不佳T2DM患者120例作为研究对象,用随机数字表法将患者分为A、B和C组,每组40例。3组均予以基础治疗,在此基础上,A组使用利拉鲁肽,B组使用沙格列汀,C组使用甘精胰岛素,治疗10周。比较3组治疗前后形态指标、糖脂代谢指标、胰岛功能指标、血清生化指标及血压,并记录患者用药后不良反应的发生情况。结果治疗后,3组患者糖脂代谢指标[空腹血糖(fasting plasma glucose,FPG)、餐后2 h血糖(2-hour postprandial blood glucose,2hPG)、平均血糖波动幅度(mean amplitude of glycemic excursions,MAGE)、糖化血红蛋白(glycated hemoglobin,HbA1c)、三酰甘油(triglyceride,TG)]、部分血清生化指标[成纤维细胞生长因子21(fibroblast growth factor 21,FGF21)、蛋白酪氨酸磷酸酶1B(protein-tyrosine phosphatase-1B,PTP1B)]均显著降低,β细胞功能指数(homeostasis model assessment ofβ-cell function,HOMA-β)显著升高(P<0.05),舒张压(diastolic blood pressure,DBP)与治疗前比较差异无统计学意义;A组体质量、腰围、体质量指数(body mass index,BMI)和收缩压(systolic blood pressure,SBP)显著降低(均P<0.05),B、C组的差异无统计学意义;A、B组的胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)显著下降(P<0.05),C组差异不显著;A组消化不良的发生率显著高于B、C组,C组轻度低血糖的发生率显著高于A、B组(P<0.05),3组不良反应发生率比较差异无统计学意义。结论3种药物均可有效调整血糖控制不佳T2DM患者的状态。利拉鲁肽可以有效改善患者的形体状态,降低患者的体脂,调节胰岛功能,但容易导致胃肠不适;甘精胰岛素致轻度低血糖的风险较高;沙格列汀对胰岛功能有修复作用,且不良反应少。Objective To compare the therapeutic effects and safety of liraglutide,saxagliptin and insulin glargine in patients with type 2 diabetes mellitus(T2DM)of poor blood glucose control.Methods 120 patients with T2DM of poor blood glucose control were selected as the research subjects.According to the random number table method,the patients were divided into group A,group B and group C,with 40 cases in each group.All the 3 groups were given basic treatment,and group A was treated with liraglutide,group B was treated with saxagliptin,and group C were treated insulin glargine.The treatment lasted for 10 weeks.The morphological indicators,glucolipid metabolism indicators,islet function indicators,serum biochemical indicators and blood pressure were compared among the 3 groups before and after treatment,and the adverse reactions after medication were recorded.Results After treatment,the glucolipid metabolism indicators[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),mean amplitude of glycemic excursions(MAGE),glycated hemoglobin(HbA1c),triglyceride(TG)]and partial serum biochemical indicators[fibroblast growth factor 21(FGF21),protein-tyrosine phosphatase-1B(PTP1B)]of the 3 groups were significantly reduced,while the homeostasis model assessment ofβ-cell function(HOMA-β)was significantly enhanced(P<0.05),but there was no significant difference in diastolic blood pressure(DBP)compared with before treatment.The body weight,waist circumference,body mass index(BMI)and systolic blood pressure(SBP)of group A were significantly reduced(P<0.05),and the differences between group B and group C were not significant.Homeostasis model assessment of insulin resistance(HOMA-IR)in group A or group B was significantly decreased(P<0.05),and there was no significant difference compared with that in group C.The incidence rate of dyspepsia of group A was significantly higher than that of groups B and C,and the incidence rate of mild hypoglycemia in group C was significantly higher than that in groups A and B(P<0.05),but

关 键 词：利拉鲁肽 沙格列汀 甘精胰岛素 血糖控制不佳2型糖尿病 安全性 

分 类 号：R977[医药卫生—药品]