替米沙坦联合卡格列净治疗2型糖尿病伴中心型肥胖患者的疗效分析  

Telmisartan combined with cagreliflozin in treatment of patients with type 2 diabetes and central obesity

作　　者：王梦琳 屈文艳 王移 Wang Menglin;Qu Wenyan;Wang Yi(Department of Endocrinology and Metabolism,Xi'an Daxing Hospital,Xi'an 710016,China;Third Outpatient Department,Air Force 986th Hospital,Xi'an 710068,China)

机构地区：[1]西安大兴医院内分泌代谢科,西安710016 [2]空军第九八六医院派驻第三门诊部,西安710068

出　　处：《国际医药卫生导报》2025年第6期1001-1005,共5页International Medicine and Health Guidance News

基　　金：陕西省自然科学基础研究计划(2020JQ-549)。

摘　　要：目的探讨替米沙坦联合卡格列净对2型糖尿病伴中心型肥胖患者的临床疗效。方法采用前瞻性研究,选取2022年1月至2024年1月西安大兴医院接收的88例2型糖尿病伴中心型肥胖患者作为研究对象。通过随机数字表法将患者分为两组,各44例。参照组:男24例,女20例,年龄41~73(54.83±9.97)岁,2型糖尿病病程4~10(6.49±1.31)年;在基础治疗的同时进行卡格列净治疗(每次剂量为100 mg,每日口服1次)。联合组:男26例,女18例,年龄42~72(55.18±10.16)岁,2型糖尿病病程4~9(6.36±1.27)年;在参照组基础上联合替米沙坦治疗(每次剂量为80 mg,每日口服1次)。两组均治疗6个月。比较两组患者治疗前后的肥胖指标[体重指数(BMI)、腰围、腰臀比、内脏脂肪面积(VFA)]、血糖指标[糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2 h血糖(2 hPBG)]、胰岛功能[胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)、空腹胰岛素(FINS)]、心血管指标[血清内皮素-1(ET-1)、血管内皮生长因子(VEGF)、血管内皮依赖性舒张功能(FMD)],以及不良反应发生情况。统计学方法采用t检验、χ^(2)检验。结果治疗后,联合组患者BMI、腰围、腰臀比、VFA、HbA1c、FBG、2 hPBG、HOMA-IR均低于参照组,FMD高于参照组,差异均有统计学意义(t=7.139、4.869、2.909、2.471、2.743、24.288、3.696、26.441、7.508,均P<0.05);联合组患者FMD水平高于参照组[(10.93±1.88)%比(8.27±1.41)%],ET-1、VEGF水平均低于参照组[(63.20±7.72)ng/L比(69.17±8.88)ng/L、(8.14±1.29)ng/L比(9.46±1.57)ng/L],差异均有统计学意义(t=7.508、3.366、4.309,均P<0.05)。两组不良反应发生率比较,差异无统计学意义(χ^(2)=1.397,P>0.05)。结论替米沙坦联合卡格列净能改善2型糖尿病伴中心型肥胖患者血糖和体重指标,调整血脂水平,治疗安全,适合临床推广应用。Objective To explore the clinical efficacy of telmisartan combined with cagreliflozin for patients with type 2 diabetes mellitus(T2DM)and central obesity.Methods This was a prospective study.Eighty-eight patients with T2DM and central obesity treated at Xi'an Daxing Hospital between January 2022 and January 2024 were selected as the study objects,and were divided into a reference group and a combination group by the random number table method,with 44 cases in each group.There were 24 males and 20 females in the reference group;they were 41-73(54.83±9.97)years old;their T2DM course was 4-10(6.49±1.31)years.There were 26 males and 18 females in the combination group;they were 42-72(55.18±10.16)years old;their T2DM course was 4-9(6.36±1.27)years.The reference group received basic treatment and orally took 100 mg of cagreliflozin once per day;in addition,the combination group orally took 80 mg of telmisartan once per day;both groups were treated for 6 months.The obesity-related indicators[body mass index(BMI),waist circumference(WC),waist-to-hip ratio(WHR),and visceral fat area(VFA)],glycemic indicators[glycated hemoglobin(HbA1c),fasting blood glucose(FBG),and 2-hour postprandial blood glucose(2 hPBG)],pancreatic islet function[homeostasis model assessment for insulin resistance(HOMA-IR),homeostasis model assessment for beta-cell function(HOMA-β),and fasting insulin(FINS)],and cardiovascular indicators[endothelin-1(ET-1),vascular endothelial growth factor(VEGF),and flow-mediated dilation(FMD)]before and after the treatment and incidence rates of adverse reactions were compared between the two groups.The statistical analysis was performed using the t andχ²tests.Results After the treatment,the BMI,WC,WHR,VFA,HbA1c,FBG,2 hPBG,and HOMA-IR in the combination group were lower than those in the reference group,while the FMD was higher,with statistical differences(t=7.139,4.869,2.909,2.471,2.743,24.288,3.696,26.441,and 7.508;all P<0.05);the FMD in the combination group was higher than that in the reference group[(10.9

关 键 词：2型糖尿病 中心型肥胖 替米沙坦 卡格列净 血糖 

分 类 号：R58[医药卫生—内分泌]