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利拉鲁肽联合胰岛素和格列吡嗪治疗亚甲减合并2型糖尿病老年患者的临床研究
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| 篇名： | 利拉鲁肽联合胰岛素和格列吡嗪治疗亚甲减合并2型糖尿病老年患者的临床研究 |
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| 摘要： | 目的：观察利拉鲁肽联合胰岛素和格列吡嗪治疗亚临床性甲状腺功能减退症（以下简称“亚甲减”）合并2型糖尿病的老年患者的效果及安全性。方法：选取2013年12月－2015年12月我院收治的亚甲减合并2型糖尿病老年患者82例，按照随机数字表法分为试验组（40例）和对照组（42例）。对照组患者给予胰岛素注射液+格列吡嗪片；试验组患者在此基础上给予利拉鲁肽注射液0.6 mg，sc，qd。两组患者均连续治疗12周。观察两组患者治疗前后的血糖[空腹血糖、餐后1 h和2 h血糖、日间血糖平均绝对差（MODD）、平均血糖波动幅度（MAGE）]、糖化血红蛋白、体质量、总胆固醇、血压（收缩压、舒张压）、促甲状腺激素（TSH）和胰岛B细胞功能指数（HOMA-B）水平，并记录不良反应发生情况。结果：对照组患者脱落4例，试验组无脱落病例。治疗前，两组患者血糖、糖化血红蛋白、体质量、总胆固醇、血压、TSH和HOMA-B等水平比较，差异均无统计学意义（P＞0.05）。治疗后，试验组患者的体质量和总胆固醇水平均明显降低，且明显低于对照组，差异均有统计学意义（P＜0.05）；两组患者血糖、糖化血红蛋白、血压和TSH水平均明显降低，HOMA-B水平明显升高，且试验组明显优于对照组，差异均有统计学意义（P＜0.05）。试验组患者总不良反应发生率（12.5％）与对照组（19.0％）比较，差异无统计学意义（P＞0.05）。结论：利拉鲁肽联合胰岛素和格列吡嗪治疗亚甲减合并2型糖尿病的老年患者，可有效降糖并稳定机体血糖水平，控制体质量增加，改善胰岛B细胞功能，且安全性较好。 |
| ABSTRACT： | OBJECTIVE： To observe the effectiveness and safety of liraglutide combined with insulin and glipizide in the treatment of subclinical hypothyroidism （SCH） complicated with type 2 diabetes in the elderly patients. METHODS： Totally 82 elderly patients with SCH complicated with type 2 diabetes were selected from our hospital during Dec. 2013-Dec. 2015， and then divided into trial group （40 cases） and control group （42 cases） according to random number table. Control group was given Insulin injection+Glipizide tablets. Trial group was additionally given Liraglutide injection 0.6 mg， sc， qd， on the basis of control group. Treatment courses of 2 groups lasted for 12 weeks. The levels of blood glucose [fasting glucose， postprandial 1 h and 2 h glucose， mean of daily differences （MODD）， mean amplitude of glycemic excursions （MAGE）]， glycosylated hemoglobin， body weight， total cholesterol， blood pressure [systolic blood pressure （SBP）， diastolic blood pressure （DBP）]， thyroid stimulating hormone （TSH） and homeostasis model assessment （HOMA-B） were observed in 2 groups before and after treatment. The occurrence of ADR was recorded. RESULTS： Totally 4 patients of control group withdrew from the study， and no one withdrew from the study in trial group. Before treatment， there was no statistical significance in the levels of blood glucose， glycosylated hemoglobin， body weight， total cholesterol， blood pressure， TSH and HOMA-B （P＞0.05）. After treatment， body weight and total cholesterol level of trial groups were significantly decreased and lower than those of control group， with statistical significance （P＜0.05）. The levels of blood glucose， glycosylated hemoglobin， blood pressure （SBP， DBP） and TSH in 2 groups were decreased significantly， while HOMA-B levels were increased significantly， and trial group was significantly better than control group， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of ADR between trial group （12.5％） and control group （19.0％） （P＞0.05）. CONCLUSIONS： Liraglutide combined with insulin and glipizide for elderly patients with SCH complicated with type 2 diabetes can effectively reduce blood glucose level， keep blood glucose stable， control the increase of body weight and improve islet B cell function with good safety. |
| 期刊： | 2017年第28卷第14期 |
| 作者： | 杨颖博，田小燕，黄一茜，李剑，李辉 |
| AUTHORS： | YANG Yingbo，TIAN Xiaoyan，HUANG Yiqian，LI Jian，LI Hui |
| 关键字： | 利拉鲁肽；亚临床性甲状腺功能减退症；2型糖尿病；血糖；胰岛B细胞功能 |
| KEYWORDS： | Liraglutide； Subclinical hypothyroidism； Type 2 diabetes； Blood glucose； Islet B cell function |
| 阅读数： | 442 次 |
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