摘要
目的探讨利拉鲁肽联合达格列净治疗肥胖2型糖尿病的效果及对患者胰岛功能的影响。方法选取2020年6月至2024年6月赣州市人民医院收治的70例肥胖2型糖尿病患者作为研究对象,采用随机数字表法分为对照组和治疗组,每组35例。对照组在常规治疗基础上采用利拉鲁肽治疗,治疗组在常规治疗基础上采用利拉鲁肽联合达格列净治疗。比较两组血糖指标[空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(postprandial 2 h blood glucose,2 h PBG)、糖化血红蛋白A1c(glycated hemoglobin A1c,HbA1c)]、血脂指标[总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)]、肥胖指数[腰臀比(waist-to-hip ratio,WHR)、体重指数(body mass index,BMI)]、胰岛功能指标[空腹胰岛素(fasting insulin,FINS)、餐后2 h胰岛素(postprandial 2 h insulin,2 h INS)、胰岛β细胞功能指数(homeostatic model assessment ofβ-cell function,HOMA-β)、胰岛素抵抗指数(homeostatic model assessment of insulin resistance,HOMA-IR)、胰岛素敏感指数(insulin sensitivity index,ISI)]、不良反应发生情况。结果治疗后,观察组FBG、2 h PBG、HbAlc水平和WHR、BMI均低于对照组,差异有统计学意义(P<0.05)。观察组TC、TG、LDL-C水平均低于对照组,HDL-C水平高于对照组,差异有统计学意义(P<0.05)。观察组FINS、2 h INS水平及HOMA-β、ISI均高于对照组,HOMA-IR低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论在常规治疗基础上,对肥胖2型糖尿病患者联用利拉鲁肽和达格列净治疗,可有效降低血糖、血脂水平与体质量,改善胰岛功能,且临床用药安全。
Objective To explore the therapeutic effect of liraglutide combined with dapagliflozin in type 2 diabetes mellitus with obesity and its influence on pancreatic islet function.Methods 70 type 2 diabetes mellitus with obesity patients admitted to Ganzhou People's Hospital from June 2020 to June 2024 were selected as the research subjects,and they were divided into the control group and the treatment group by the random number table method,with 35 cases in each group.On the basis of conventional treatment,the control group was treated with liraglutide,while the treatment group was treated with liraglutide combined with dapagliflozin.The blood glucose indicators(fasting blood glucose[FBG],postprandial 2 h blood glucose[2 h PBG],glycated hemoglobin A1c[HbA1c]),blood lipid indicators(total cholesterol[TC],low-density lipoprotein cholesterol[LDL-C],triglyceride[TG],high-density lipoprotein cholesterol[HDL-C]),obesity index(waist-to-hip ratio[WHR],body mass index[BMI]),islet function indicators(fasting insulin[FINS],postprandial 2 h insulin[2 h INS],homeostatic model assessment ofβ-cell function[HOMA-β],homeostatic model assessment of insulin resistance[HOMA-IR],insulin sensitivity index[ISI])and adverse reactions were compared between the two groups.Results After treatment,the levels of FBG,2 h PBG,HbAlc and WHR,BMI in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of TC,TG and LDL-C in the observation group were lower than those in the control group,while the level of HDL-C was higher than that in the control group,and the differences were statistically significant(P<0.05).The FINS,2 h INS levels and HOMA-β,ISI in the observation group were higher than those in the control group,while HOMA-IR was lower than that in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups.Conclusion On the basis of conventional treatment,the combination of liraglutide and dapagliflozin for type 2 diabetes mellitus with obesity patients can effectively lower blood sugar,lipid levels and body weight,improve pancreatic islet function,and the clinical medication is safe.
作者
刘玉芬
邓修鑫
谢芳丹
LIU Yufen;DENG Xiuxin;XIE Fangdan(Department of Pharmacy,Ganzhou People's Hospital,Ganzhou,Jiangxi,341000,China;Department of Pharmacy and Medical Devices,Ganzhou Third People's Hospital,Ganzhou,Jiangxi,341000,China)
出处
《当代医学》
2025年第13期76-80,共5页
Contemporary Medicine
关键词
利拉鲁肽
达格列净
肥胖2型糖尿病
胰岛功能
Liraglutide
Dapagliflozin
Type 2 diabetes mellitus with obesity
Pancreatic islet function
