卡格列净联合德谷胰岛素利拉鲁肽、吡格列酮二甲双胍治疗肥胖T2DM效果及对胰岛素敏感性影响  

Effect of calaglitzin combined with Degu insulin liraglutide and pioglitazone metformin in the treatment of obese type 2 diabetes mellitus and its effect on insulin sensitivity

作　　者：王晓依 张桢[2] 韩洁[1] 刘慧[1] 杨琤琤 陈慧慧[1] Wang Xiaoyi;Zhang Zhen;Han Jie;Liu Hui;Yang Chengcheng;Chen Huihui(Department of Pharmacy,the First People’s Hospital of Shangqiu,Shangqiu 476100,China;Department of Endocrinology,the First People’s Hospital of Shangqiu,Shangqiu 476100,China)

机构地区：[1]商丘市第一人民医院药学部,商丘476100 [2]商丘市第一人民医院内分泌科,商丘476100

出　　处：《中华内分泌外科杂志（中英文）》2024年第5期728-732,共5页Chinese Journal of Endocrine Surgery

基　　金：河南省医学科技攻关计划(LHGJ20230984)。

摘　　要：目的分析卡格列净联合德谷胰岛素利拉鲁肽,吡格列酮二甲双胍治疗肥胖2型糖尿病(type 2 diabetes mellitus,T2DM)效果。方法选取商丘市第一人民医院2021年4月至2023年6月收治的99例肥胖T2DM患者,按照治疗方法不同分为两组,对照组(n=52)采取德谷胰岛素利拉鲁肽,吡格列酮二甲双胍治疗,观察组(n=47)在对照组基础上另加用卡格列净治疗,两组均治疗8周,对比两组治疗效果。结果观察组治疗有效率95.74%(45/47)高于对照组82.69%(43/52)(P<0.05)。治疗8周后,观察组空腹血糖(fasting blood glucose,FBG)(7.96±0.74)mmol/L、餐后2 h血糖(2-hour postprandial blood glucose,2 hPG)(8.36±1.02)mmol/L、身体质量指数(body mass index,BMI)(24.63±1.51)kg/m^(2)水平较对照组(8.69±0.81)mmol/L、(9.21±1.27)mmol/L、(25.46±1.86)kg/m^(2)低(P<0.05)。治疗8周后,观察组胰岛素抵抗指数(Homeostasis model assessment-insulin resistance index,HOMA-IR)(2.41±0.56)较对照组(2.84±0.61)低,葡萄糖输注率(glucose infusion rate,GIR)(5.63±0.97)mg·kg^(-1)·min^(-1)较对照组(5.17±0.95)mg·kg^(-1)·min^(-1)高(P<0.05)。治疗8周后,观察组三酰甘油(triacylglycerol,TG)(4.22±0.43)mmol/L、总胆固醇(total cholesterol,TC)(2.15±0.21)mmol/L、载脂蛋白B(apolipoprotein B,ApoB)(1.18±0.14)mmol/L,较对照组(2.49±0.26)mmol/L、(4.69±0.47)mmol/L、(1.45±0.19)mmol/L低(P<0.05)。观察组不良反应发生率8.51%(4/47),较对照组5.77%(3/52)高,但差异无统计学意义(P>0.05)。结论采取卡格列净联合德谷胰岛素利拉鲁肽,吡格列酮二甲双胍可显著降低胰岛素抵抗,增加外周组织对胰岛素的敏感性,降低血糖水平和BMI水平,用药安全性尚可。ObjectiveTo evaluate the efficacy of calaglitzin combined with Degu insulin Liraglutide and pioglitazone metformin in the treatment of obese type 2 diabetes mellitus(T2DM).MethodsNinety-nine obese T2DM patients admitted to our hospital from Apr.2021 to Jun.2023 were divided into 2 groups according to different treatment methods.The control group(n=52)were treated with Delgu insulin liraglutide and pioglitazone metformin;the observation group(n=47)were treated with cagaglizin on the basis of the control group,and both groups were treated for 8 weeks.The therapeutic effect of the two groups was compared.ResultsThe effective rate of observation group was 95.74%(45/47),higher than that of control group 82.69%(43/52)(P<0.05).After eight weeks of treatment,the levels of FPG(7.96±0.74)mmol/L,2hPBG(8.36±1.02)mmol/L and BMI(24.63±1.51)kg/m^(2)in the observation group were higher than those in the control group(P<0.05).After 8 weeks of treatment,HOMA-IR(2.41±0.56)of observation group was lower than that of control group(2.84±0.61),GIR(5.63±0.97)mg·kg^(-1)·min^(-1) was higher than that of the control group(5.17±0.95)mg·kg^(-1)·min^(-1)(P<0.05).After eight weeks of treatment,the levels of TG(4.22±0.43)mmol/L,TC(2.15±0.21)mmol/L and ApoB(1.18±0.14)mmol/L in the observation group were higher than those in the control group(2.49±0.26)mmol/L,(4.69±0.47)mmol/L and(1.45±0.19)mmo l/L(P<0.05).The incidence of adverse reactions in the observation group was 8.51%(4/47),lower than that in the control group(5.77%(3/52)(P>0.05)).ConclusionTaking calaglitzin in combination with Delgu insulin liraglutide and pioglitazone metformin can significantly reduce insulin resistance,increase the sensitivity of peripheral tissues to insulin,reduce blood glucose level and BMI level,and the drug safety is reasonable.

关 键 词：卡格列净 德谷胰岛素利拉鲁肽 吡格列酮二甲双胍 肥胖 2型糖尿病 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]