摘要
目的研究司美格鲁肽治疗老年2型糖尿病合并认知障碍患者的疗效及安全性。方法选择2022年1月-2024年1月海南省老年病医院诊治的106例老年2型糖尿病合并认知障碍患者为研究对象,采用随机数字表法分为SMG组和N-GLP-1组,每组53例。SMG组给予司美格鲁肽治疗,N-GLP-1组给予非GLP-1类降糖药物治疗,比较两组生化指标[空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]、认知功能[简易精神状态检查量表(MMSE)、日常生活能力量表(Barthel指数)]、颅脑损伤标志物[Tau蛋白、β-淀粉样蛋白42(Aβ42)、磷酸化Tau181(p-Tau181)]。结果SMG组治疗后FPG、HbA1c、FINS和HOMA-IR低于N-GLP-1组(P<0.05);SMG组患者治疗后6、12个月MMSE评分、Barthel指数高于N-GLP-1组,Tau蛋白、Aβ42及p-Tau181均低于N-GLP-1组(P<0.05);两组消化道反应、肝肾功能损伤、低血糖反应和骨髓抑制等并发症发生率比较,均无统计学差异(P>0.05)。结论司美格鲁肽治疗老年2型糖尿病合并认知障碍患者可改善患者血糖、胰岛素抵抗及认知功能障碍,具有高效安全的优点,其疗效高于传统的非GLP-1类降糖药物。
Objective To investigate the efficacy and safety of semaglutide in the treatment of elderly patients with type 2 diabetes mellitus and cognitive impairment.Methods A total of 106 elderly patients with type 2 diabetes mellitus complicated with cognitive impairment who were treated in Hainan Geriatrics Hospital from January 2022 to January 2024 were selected as the research objects.They were divided into SMG group and N-GLP-1 group by random number table method,with 53 patients in each group.The SMG group was treated with smeglutide,and the N-GLP-1 group was treated with Non-GLP-1 hypoglycemic drugs.The biochemical indexes[fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),fasting insulin(FINS),insulin resistance index(HOMA-IR)],cognitive function[Mini-mental State Examination Scale(MMSE),activity of daily living scale(Barthel index)],craniocerebral injury markers[Tau protein,β-amyloid 42(Aβ42),phosphorylated Tau181(p-Tau181)]were compared between the two groups.Results After treatment,FPG,HbA1 c,FINS and HOMA-IR in the SMG group were lower than those in the N-GLP-1 group(P<0.05).The MMSE score and Barthel index in the SMG group were higher than those in the N-GLP-1 group at 6 and 12 months after treatment,and the Tau protein,Aβ42 and p-Tau181 were lower than those in the N-GLP-1 group(P<0.05).There was no significant difference in the incidence of complications such as gastrointestinal reaction,liver and kidney function injury,hypoglycemia and bone marrow suppression between the two groups(P>0.05).Conclusion Semeglutide can improve blood glucose,insulin resistance and cognitive dysfunction in elderly patients with type 2 diabetes mellitus complicated with cognitive impairment.It has the advantages of high efficiency and safety,and its curative effect is higher than that of traditional Non-GLP-1 hypoglycemic drugs.
作者
胡琼文
鲁金胜
邓晓娟
HU Qiongwen;LU Jinsheng;DENG Xiaojuan(Department of Geriatrics,Hainan Provincial Geriatric Hospital,Haikou 571100,Hainan,China;Department of Pharmacy,Hainan Provincial Geriatric Hospital,Haikou 571100,Hainan,China)
出处
《医学信息》
2025年第23期122-125,130,共5页
Journal of Medical Information
基金
海南省卫生健康行业科研项目(编号:22A200281)。
