利拉鲁肽对首诊2型糖尿病患者血糖、血脂及T细胞亚群的影响

目的 探讨利拉鲁肽治疗首诊超重或肥胖2型糖尿病患者的效果及其对T细胞亚群的影响。方法 选取2018年2月~2019年6月我院收治的72例确诊为2型糖尿病超重或肥胖患者，采用随机数字表法分为对照组和研究组，每组36例。对照组予以常规治疗，研究组在对照组基础上加用利拉鲁肽治疗，比较两组治疗前后血糖水平（FPG、BPG、HbA1c）、空腹胰岛素+C肽、餐后2h胰岛素+C肽水平、BMI、血脂（HDL-C、LDL-C、VLDL-C、TC、TG）以及CD4+、CD4+/CD8+水平。结果 治疗后，研究组FPG、BPG、HBA1c水平低于对照组（P＜0.05），空腹胰岛素、餐后2h胰岛素和空腹C肽、餐后2h C肽水平高于对照组（P＜0.05）；研究组BMI水平低于对照组（P＜0.05）；研究组TG、TC、LDL-C、VLDL-C水平低于对照组，HDL-C水平高于对照组（P＜0.05）；研究组CD4+、CD4+/CD8+高于对照组（P＜0.05）。结论 利拉鲁肽可调节CD4+T细胞亚群平衡，改善胰岛素β细胞功能并降低胰岛素抵抗，可更好控制2型糖尿病患者血糖水平，改善血脂水平，降低体质量。

Effect of Liraglutide on Blood Glucose,Blood Lipids and T cell Subsets in Patients with Type 2 Diabetes Mellitus

Objective To investigate the effect of liraglutide in the treatment of patients with overweight or obesity type 2 diabetes and its effect on T cell subsets. Methods 72 patients with type 2 diabetes who were overweight or obese were enrolled in our hospital from February 2018 to June 2019. They were randomly divided into the control group and the study group, with 36 cases in each group. The control group received routine treatment. The study group was treated with liraglutide on the basis of the control group. The blood glucose levels (FPG, BPG, HbA1c), fasting insulin + C peptide, and postprandial 2h insulin + C peptide levels were compared before and after treatment, BMI, blood lipids (HDL-C, LDL-C, VLDL-C, TC, TG) and CD4+, CD4+/CD8+ levels. Results After treatment, the levels of FPG, BPG and HBA1c in the study group were lower than those in the control group (P<0.05). The levels of fasting insulin, 2h postprandial insulin and fasting C-peptide, and 2h C-peptide after meal were higher than those in the control group (P<0.05). The BMI level of the group was lower than that of the control group (P<0.05). The levels of TG, TC, LDL-C and VLDL-C in the study group were lower than those in the control group, and the HDL-C level was higher than that in the control group (P<0.05). The study group CD4+, CD4+/CD8+ was higher than the control group (P<0.05). Conclusion Liraglutide can regulate the balance of CD4+ T cell subsets, improve insulin β cell function and reduce insulin resistance, which can better control blood glucose levels, improve blood lipid levels and reduce body mass in patients with type 2 diabetes.