利拉魯肽與胰島素泵對新診斷的2型糖尿病肥胖患者臨床療效比較

　　[摘要]目的 比較利拉魯肽與胰島素泵持續(xù)皮下輸注（CSII）對新診斷的2 型糖尿病肥胖患者的療效。方法 選取2015年10月～2016年10月我科收治的新診斷且未經(jīng)任何降糖藥物治療的64例2型糖尿病肥胖患者作為研究對象，隨機(jī)分為利拉魯肽皮下注射組和胰島素泵持續(xù)泵入組，均治療4周。比較兩組患者治療前后空腹及餐后2 h的血糖、空腹胰島素、糖化血紅蛋白、體重指數(shù)及腰圍變化等情況。結(jié)果 兩組患者治療后空腹血糖（FPG）、餐后2 h血糖（2 h PG）、空腹胰島素（FINS）、糖化血紅蛋白（HbA1c）均較同組治療前顯著改善，組間比較差異無統(tǒng)計(jì)學(xué)意義（P>0.05）；利拉魯肽組體重指數(shù)（BMI）及腰圍較治療前顯著改善，與胰島素泵組比較，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 對于新診斷的2 型糖尿病肥胖患者，應(yīng)用利拉魯肽降糖治療，可有效降低血糖水平，改善胰島β細(xì)胞的功能，與胰島素泵降糖的療效相當(dāng)，并且有減輕體重及腰圍的優(yōu)勢。
　　[關(guān)鍵詞]2型糖尿��；利拉魯肽；胰島素泵
　　[中圖分類號] R587.1 [文獻(xiàn)標(biāo)識碼] A [文章編號] 1674-4721（2018）2（b）-0044-03
　　Comparison of clinical efficacy of Liraglutide and Insulin pump in newly diagnosed obese patients with type 2 diabetes mellitus
　　ZHAO Sa SHI Yi-shan
　　Department of Endocrinology，the Second Affiliated Hospital of Shenyang Medical College in Liaoning Province，Shenyang 110002，China
　　[Abstract]Objective To compare the efficacy of Liraglutide and continuous subcutaneous Insulin infusion （CSII） via pump in newly diagnosed obese patients with type 2 diabetes mellitus.Methods From October 2015 to October 2016，a total of 64 patients with newly-diagnosed type 2 diabetes mellitus （DM） without application of antidiabetic drugs treated in our department were randomly divided into Liraglutide hypodermic injection group and continuous Insulin pump group.The treatment was lasted for 4 weeks.The fasting and 2-hour postprandial blood glucose，Insulin level in fasting，glycosylated hemoglobin （HbA1c），body mass index （BMI），and waist circumference were compared before and after treatment between the two groups.Results The fasting plasma glucose （FPG），2-hour postprandial blood glucose （2 h PG），fasting Insulin （FINS），and HbA1c were significantly improved in the two groups compared with those before treatment，but there was no significant difference in inter-group comparisons.The BMI and waist circumference in Liraglutide group were obviously improved compared with those before treatment，and also displayed statistical differences in comparison of Insulin pump group.Conclusion For the newly diagnosed obese patients with type 2 diabetes，the application of Liraglutide for blood glucose reduction can effectively reduce the blood glucose level，improve the function of islet β cells，and the effect is tantamount to that by Insulin pump.The former has the advantages of reducing body weight and waist circumference.
　　[Key words]Type 2 diabetes；Liraglutide；Insulin pump
　　全球超重和肥胖人數(shù)不斷增長，中國的超重和肥胖人數(shù)位列美國之后，處于全球第二。肥胖會帶來糖尿病、高血壓等慢性病，整個(gè)社會都會為肥胖付出很多的經(jīng)濟(jì)成本。肥胖者發(fā)生2型糖尿病的風(fēng)險(xiǎn)是正常人群的2～4倍。大量研究顯示對初診的2型糖尿病患者進(jìn)行胰島素強(qiáng)化治療， 可以在較短時(shí)間內(nèi)使患者的血糖得到有效控制，改善胰島素抵抗，而對于肥胖的初診2型糖尿病患者，選擇胰島素強(qiáng)化治療又擔(dān)心胰島素會增加患者體重，不利于血糖的長期控制。近年來胰高血糖素樣肽1（GLP-1）受體激動(dòng)劑的問世給這種患者增加了新的選擇。已有相關(guān)研究提示GLP-1受體激動(dòng)劑不僅可降低空腹血糖（FBG）及餐后2 h血糖（2 h PG），而且具有減輕體重及腰圍的作用[1]，代表藥物有利拉魯肽等。本研究比較了利拉魯肽與胰島素泵對新診斷的2型糖尿病肥胖患者的療效，現(xiàn)報(bào)道如下。

相關(guān)熱詞搜索：肥胖 療效 糖尿病 臨床 患者