利拉鲁肽联合阿卡波糖治疗肥胖型2型糖尿病临床疗效观察

目的探讨利拉鲁肽联合阿卡波糖治疗肥胖型2型糖尿病(T2DM)的临床疗效。方法将2010年2月至2013年6月沧州市中心医院南院区内分泌科收治的98例肥胖型T2DM患者按随机数字表法分为两组:对照组(49例)应用阿卡波糖治疗,治疗组(49例)应用利拉鲁肽联合阿卡波糖治疗,观察两组治疗前后的血糖、血脂水平及体质量指数(BMI)、空腹胰岛素、稳态模型评估的胰岛β细胞功能指数(HOMA-β)和血清nesfatin-1水平变化情况。结果两组患者治疗后空腹血糖、餐后2 h血糖、糖化血红蛋白、胆固醇、三酰甘油水平均较治疗前显著降低,且治疗组低于对照组,差异均有统计学意义(P<0.05);治疗后治疗组BMI较治疗前降低(P<0.05),HOMA-β值和血清nesfatin-1水平较治疗前增加(P<0.05),对照组BMI、HOMA-β值和血清nesfatin-1水平治疗前后差异无统计学意义(P>0.05)。结论利拉鲁肽联用阿卡波糖通过升高血清nesfatin-1水平、降低BMI、改善糖脂代谢对肥胖型T2DM起到治疗作用,可作为肥胖型T2DM的优选治疗方案。

Observation of Clinical Effect of Liraglutide Combined with Acarbose on Type 2 Diabetes Mellitus with Obesity

Objective To investigate the clinical effect of liraglutide and aearbose on type 2 diabetes mellitus（T2DM） in obese people. Methods A total of 98 obese patients with T2DM admitted to the Southern Courtyard of Cangzhou Central Hospital from Feb. 2010 to Jun. 2013 were divided into 2 groups by random number table method, the control group（49 cases） were treated with acarbose,the observation group （49 cases） were treated with liraglntide and acarbose,and the changes of the blood glucose and blood lipid levels ,body mass index（BMI） ,fasting insulin（ FINS）, insulin secretion index HOMA-β and nesfatin-1 levels in the serum of patients of the two groups before and after treatment were observed. Results FPG,2hPG, HbA1 c ,TG, TC levels of patients in both groups decreased significantly than before treatment （P 〈 0.05 ） , the observation group was lower than the control group with statistically significant difference （P 〈 0.05 ） ;in the observation group ： BMI decreased after treatment than before treatment （ P 〈 0.05 ）, HOMA-β values and serum nesfatin-1 levels increased than before treatment,（ P 〈 0.05 ）, BMI, HOMA-β values and the levels of serum nesfatin-I of the control group had no significant differences before and after treatment （P 〉 0. 05 ）. Conclusion Liraglutide and acarbose has therapeutic effect for T2DM with obesity by increasing the serum level of nesfatin-1, reducing BMI, and improving glucolipid metabolism, thus can be used as the preferred therapy for T2DM with obesity.