利拉鲁肽联合德谷胰岛素对老年肥胖T2DM患者血管内皮功能和胰岛功能的影响  

Effect of liraglutide combined with insulin degludec on vascular endothelial function and pancreatic islet function in elderly obese patients with type 2 diabetes mellitus

作　　者：郑弟蓉 吴灵莉 ZHENG Dirong;WU Lingli(Department of Pharmacy,Wuyishan Municipal Hospital,Fujian Province,Wuyishan 354300,China)

机构地区：[1]武夷山市立医院药剂科,福建省武夷山市354300

出　　处：《临床合理用药》2025年第1期29-32,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察利拉鲁肽联合德谷胰岛素对老年肥胖2型糖尿病(T2DM)患者血管内皮功能和胰岛功能的影响。方法选择2021年1月—2023年12月武夷山市立医院接收的老年肥胖T2DM患者153例,采用随机数字表法分为观察组76例和对照组77例。对照组单用德谷胰岛素治疗,观察组在对照组的基础上联合利拉鲁肽治疗。治疗12周后,比较2组血糖控制效果,治疗前后肥胖指标[体质指数(BMI)、腹围、臀围]、血管内皮功能指标[一氧化氮(NO)、内皮素-1(ET-1)、血管内皮生长因子(VEGF)]、炎性因子[白介素-6(IL-6)、白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)]、胰岛功能指标[空腹胰岛素(FINS)、空腹C肽(FCP)、胰岛素抵抗指数(HOMA-IR)]及不良反应。结果观察组血糖控制总有效率高于对照组(98.68%vs.89.61%,χ^(2)=4.167,P=0.041)。治疗12周后,2组BMI及ET-1、VEGF、IL-6、TNF-α、FINS、FCP水平和HOMA-IR降低,腹围、臀围减小,NO、IL-10水平升高,且观察组变化幅度大于对照组(P<0.01)。观察组不良反应总发生率与对照组比较差异无统计学意义(13.16%vs.15.58%,χ^(2)=0.182,P=0.668)。结论利拉鲁肽联合德谷胰岛素治疗老年肥胖T2DM患者,能显著提高血糖控制效果,降低患者体质量,减轻血管内皮损伤,调节炎性因子表达,改善胰岛功能,且未发生严重不良反应,安全性高。Objective To observe the effect of liraglutide combined with insulin degludec on vascular endothelial function and pancreatic islet function in elderly obese patients with type 2 diabetes mellitus(T2DM).Methods One hundred and fifty-three cases of elderly obese T2DM patients received by Wuyishan Municipal Hospital from January 2021 to December 2023 were selected,and they were divided into observation group(76 cases)and control group(77 cases)by using the randomized numerical table method.The control group was treated with insulin degludec alone,and the observation group was combined with liraglutide on the basis of the control group.After 12 weeks of treatment,the effect of glycemic control,obesity indexes(BMI,abdominal circumference,hip circumference),vascular endothelial function index(NO,ET-1,VEGF),inflammatory factors(IL-6,IL-10,TNF-α),islet function indicators(FINS,FCP,HOMA-IR)before and after treatment,and adverse reactions were compared between the two groups.Results The total effective rate of glycemic control in the observation group was higher than that in the control group(98.68%vs.89.61%,χ^(2)=4.167,P=0.041).After 12 weeks of treatment,BMI and the levels of ET-1,VEGF,IL-6,TNF-α,FINS,FCP and HOMA-IR were decreased in the two groups,abdominal circumference and hip circumference were reduced,the levels of NO,IL-10 increased,and the magnitude of change in the observation group was greater than that in the control group(P<0.01).The difference between the total incidence of adverse reactions in the observation group and the control group was not statistically significant(13.16%vs.15.58%,χ^(2)=0.182,P=0.668).Conclusion Liraglutide combined with insulin degludec in the treatment of elderly obese patients with T2DM can significantly improve the effect of glycemic control,reduce the patient's body mass,reduce vascular endothelial damage,regulate the expression of inflammatory factors,improve pancreatic islet function,and no serious adverse reactions occurred,high safety.

关 键 词：2型糖尿病 肥胖 老年 利拉鲁肽 德谷胰岛素 血管内皮功能 胰岛功能 炎性因子 

分 类 号：R587.1[医药卫生—内分泌]