德谷胰岛素利拉鲁肽注射液对血糖控制不佳的2型糖尿病的疗效观察分析  

Analysis of the Therapeutic Effect of Insulin Degludec and Liraglutide Injection on Type 2 Diabetes Mellitus with Poor Glycemic Control

作　　者：赵力莹 王君 ZHAO Liying;WANG Jun(The Second Clinical College of Jinan University,Shenzhen Guangdong 518020,China;Shenzhen People's Hospital(The Second Clinical College of Jinan University,The First Affiliated Hospital of Southern University of Science and Technology),Shenzhen Guangdong 518020,China.)

机构地区：[1]暨南大学第二临床医学院,广东深圳518020 [2]深圳市人民医院(暨南大学第二临床医学院,南方科技大学第一附属医院),广东深圳518020

出　　处：《药品评价》2024年第5期605-609,共5页Drug Evaluation

基　　金：深圳市科技计划项目基础研究面上项目(JCYJ 20220530152813030)。

摘　　要：目的分析德谷胰岛素利拉鲁肽注射液对血糖控制不佳的2型糖尿病的治疗效果。方法选取深圳市人民医院收治的2型糖尿病患者24例,给予德谷胰岛素利拉鲁肽注射液治疗,观察这24例患者在治疗12周后其体质量(WT)、体质量指数(BMI)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、尿酸(UA)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、谷草转氨酶(AST)、谷丙转氨(ALT)、血肌酐(SCR)、肾小球滤过率(eGFR)、尿素氮(BUN)、血清白蛋白(ALB)的变化,同时观察不良反应发生情况。此外,其中12例患者在治疗4周后也进行了以上指标的复查,并对其进行分层数据研究。结果德谷胰岛素利拉鲁肽注射液治疗4周后,患者的WT、BMI、FPG、2 hPG、HbA1c、TG、SCR、eGFR、BUN较治疗前明显改善(P<0.05),而UA、TC、LDL-C、HDL-C、AST、ALT、ALB虽有所改善但差异无统计学意义(P>0.05)。治疗12周后,患者的WT、BMI、FPG、2 hPG、HbA1c、TC、ALT、eGFR、BUN、ALB较治疗前明显改善(P<0.05),而UA、TG、LDL-C、HDL-C、AST、SCR亦有改善,但差异无统计学意义(P>0.05),其中HbA1c治疗后的下降值为(2.23±1.56)%,HbA1c下降的程度与患者基础FPG(r=0.60,P=0.002)、2 hPG(r=0.57,P=0.007)相关。WT治疗后的下降值为(3.12±3.95)kg,WT下降程度与患者基础WT(r=0.37,P=0.078)、BMI(r=0.17,P=0.452)相关程度不大。治疗过程中有2人发生低血糖2次,低血糖发生率为8.33%,无严重低血糖事件的发生。4人出现轻微胃肠道反应,但在治疗大概1周后可耐受,无患者因为胃肠道反应退出实验。结论德谷胰岛素利拉鲁肽注射液对血糖控制不佳(HbA1c>7%)的2型糖尿病患者具有良好的降糖效果,同时对患者的血脂、肝功能、肾功能均有一定的改善,还有显著的减重效果,并且具有良好的安全性。Objective To analyze the therapeutic effect of insulin degludec and liraglutide injection on type 2 diabetes mellitus with poor glycemic control.Methods Selected 24 patients with type 2 diabetes from Shenzhen People's Hospital,treated with insulin degludec and liraglutide injection.Observed the changes of these 24 patients in their body weight(WT),body mass index(BMI),fasting plasma glucose(FPG),2-hour postprandial plasma glucose(2 hPG),glycated hemoglobin A1c(HbA1c),uric acid(UA),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),aspartate aminotransferase(AST),alanine aminotransferase(ALT),serum creatinine(SCR),glomerular filtration rate(eGFR),blood urea nitrogen(BUN)and Serum albumin(ALB)after 12 weeks of treatment as well as the side effects were observed.In addition,12 patients were reexamined for the above indicators after 4 weeks of treatment,and stratified data analysis was conducted.Results After 4 weeks of treatment with insulin degludec and liraglutide injection,the patients showed significant improvements in WT,BMI,FPG,2 hPG,HbA1c,TG,SCR,eGFR and BUN(P<0.05).The levels of UA,TC,LDL-C,HDL-C,AST,ALT and ALB were also improved but not statistically significant(P>0.05).After 12 weeks of treatment,the patients'WT,BMI,FPG,2 hPG,HbA1c,TC,ALT,eGFR,BUN and ALB were significantly improved compared with those before treatment(P<0.05),although the patients'UA,TG,LDL-C,HDL-C,AST,SCR were improved,the differences were not statistically significant(P>0.05).In addition,the reduction of HbA1c after treatment was(2.23±1.56)%,and the degree of reduction of HbA1c was correlated with baseline FPG(r=0.60,P=0.002)and 2 hPG(r=0.57,P=0.007).The decrease of WT after treatment was(3.12±3.95)kg,and the decrease of WT was not correlated with the baseline WT(r=0.367,P=0.078)and BMI(r=0.171,P=0.452).During the treatment,2 patients had hypoglycemia twice and the incidence of hypoglycemia was 8.33%.No serious hypoglycemic events occurred.Four patients had mi

关 键 词：德谷胰岛素利拉鲁肽注射液 2型糖尿病 血糖 减重 GLP-1受体激动剂 

分 类 号：R587.1[医药卫生—内分泌]