利拉鲁肽对2型糖尿病轻度认知功能障碍患者代谢指标、炎性因子及认知功能的影响  

Effect of Liraglutide on Metabolic Indicators,Inflammatory Factor and Cognitive Function in Type 2 Diabetes Mellitus Patients with Mild Cogni⁃tive Impairment

作　　者：李晓玲 赵会懂 高明秀 刘艳如 胡丽叶 LI Xiaoling;ZHAO Huidong;GAO Mingxiu;LIU Yanru;HU Liye(Department of Endocrinology,the 980th Hospital of Joint Logistic Support Force of the PLA,Shijiazhuang 050082,China;Department of Medical Information Data,the 980th Hospital of Joint Logistic Support Force of the PLA,Shijiazhuang 050082,China;Department of Psychology,the 980th Hospital of Joint Logistic Support Force of the PLA,Shijiazhuang 050082,China;Department of Health Management,the 980th Hospital of Joint Logistic Support Force of the PLA,Shijiazhuang 050082,China)

机构地区：[1]中国人民解放军联勤保障部队第九八〇医院内分泌科,石家庄050082 [2]中国人民解放军联勤保障部队第九八〇医院医学信息数据室,石家庄050082 [3]中国人民解放军联勤保障部队第九八〇医院精神心理科,石家庄050082 [4]中国人民解放军联勤保障部队第九八〇医院健康管理科,石家庄050082

出　　处：《临床误诊误治》2025年第7期44-49,共6页Clinical Misdiagnosis & Mistherapy

基　　金：河北省卫健委指令性课题(20210231);河北省中医药管理局科研计划项目(2021216)。

摘　　要：目的观察联合利拉鲁肽对2型糖尿病(T2DM)合并轻度认知功能障碍(MCI)患者糖脂代谢指标、血清同型半胱氨酸(Hcy)和超敏C反应蛋白(hs⁃CRP)水平、认知功能的影响。方法选择2021年6月至2023年1月收治70例T2DM合并MCI患者,随机分为2组,每组35例,研究期间2组各有2例未按时复诊自愿退出研究。对照组予以二甲双胍,观察组予以二甲双胍联合利拉鲁肽,均治疗6个月。比较2组治疗前后糖脂代谢指标、血清hs⁃CRP和Hcy水平、蒙特利尔认知评估量表(MoCA)评分变化,并观察不良反应发生情况。结果治疗后,2组空腹血糖、餐后2 h血糖、糖化血红蛋白(HbA1c)、低密度脂蛋白胆固醇(LDL⁃C)以及血清hs⁃CRP、Hcy水平较治疗前下降(P<0.05)。与对照组比较,观察组治疗后HbA1c、LDL⁃C以及血清Hcy水平降低更明显(P<0.05)。治疗后,观察组MoCA评分较治疗前和对照组明显升高(P<0.05)。2组治疗期间均无明显不良反应及低血糖发生。结论利拉鲁肽可显著改善T2DM合并MCI患者糖脂代谢指标,降低血清hs⁃CRP、Hcy水平,改善认知功能,且不增加不良反应,有利于防治痴呆。Objective To observe the effects of Liraglutide on glucose and lipid metabolism indexes,serum homocys⁃teine(Hcy)and high⁃sensitivity C reactive protein(hs⁃CRP)levels and cognitive function in patients with type 2 diabetes mellitus(T2DM)combined with mild cognitive impairment(MCI).Methods A total of 70 patients with T2DM and MCI admitted from June 2021 to January 2023 were randomly divided into two groups,with 35 patients in each group.During the study period,2 patients in each group did not return to the hospital on time and voluntarily withdrew from the study.The con⁃trol group was given Metformin,and the observation group was given Metformin combined with Liraglutide.Both groups were treated for 6 months.The changes of glucose and lipid metabolism indexes,serum levels of hs⁃CRP and Hcy,and Montreal cognitive Assessment(MoCA)score before and after treatment were compared between the two groups,and the occurrence of adverse reactions was observed.Results After treatment,the levels of fasting blood glucose,2⁃hour postprandial blood glu⁃cose,glycosylated hemoglobin(HbA1c),low⁃density lipoprotein cholesterol(LDL⁃C),serum hs⁃CRP and Hcy in the two groups were lower than those before treatment(P<0.05).Compared with the control group,the levels of HbA1c,LDL⁃C and serum Hcy in the observation group were more significantly decreased after treatment(P<0.05).After treatment,the MoCA score of the observation group was significantly higher than that before treatment and that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions and hypoglycemia between the two groups dur⁃ing treatment(P>0.05).Conclusion Liraglutide can significantly improve the glucose and lipid metabolism indexes of T2DM patients with MCI,reduce the levels of serum hs⁃CRP and Hcy,improve cognitive function,and does not increase ad⁃verse reactions,which is conducive to the prevention and treatment of dementia.

关 键 词：2型糖尿病 轻度认知功能障碍 利拉鲁肽 二甲双胍 空腹血糖 低密度脂蛋白胆固醇 同型半胱氨酸 超敏C反应蛋白 低血糖 

分 类 号：R587.2[医药卫生—内分泌]