降糖药利拉鲁肽的药理分析与非降糖作用的优势评价

目的探讨利拉鲁肽治疗非初诊2型糖尿病的临床疗效。方法选取2013年1月至2014年6月来院门诊就诊的口服降糖药物血糖控制不佳的2型糖尿病患者100例,按照随机数字表法分为观察组和对照组各50例,其中对照组给予甘精胰岛素治疗,观察组在对照组的基础上加用利拉鲁肽治疗,以治疗12周为观察节点。观察两组治疗前后空腹血糖(FBG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、总体胰岛素敏感指数(WBISI)、三酰甘油(TG)、胆固醇(TG)、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)、体质量指数(BMI)、腰围(WC)、臀围(HC)及收缩压(SBP)、舒张压(DBP)的变化情况,记录不良反应发生情况。结果治疗前两组的FBG、2hPG、HbA1c、FINS、HOMA-IR、WBISI、TC、TG、HDL-C、LDL-C、BMI、WC、HC、SBP、DBP比较差异无统计学意义(P>0.05);治疗后两组FBG、2hPG、HbA1c、均较治疗前明显改善,差异具有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05);治疗后观察组FINS、HOMA-IR、WBISI、BMI、WC、HC、TC、TG、HDL-C、LDL-C、SBP、DBP明显优于治疗前和对照组治疗后,差异具有统计学意义(P<0.05),对照组治疗前后比较差异无统计学意义(P>0.05)。两组患者均为发生严重不良反应,对照组发生低血糖事件5例。观察组有4例患者发生胃肠道不良反应。结论利拉鲁肽治疗经口服降糖药物血糖控制不佳的2型糖尿病不但能良好的控制血糖水平,同时可以减轻胰岛素抵抗,增强胰岛素敏感性,降低低血糖事件发生率,并且可以减轻体质量,降低血压和调节血脂水平,优势明显,值得临床推广应用。

The Advantage Evaluation of the Liraglutide in Treatment of the Non First Diagnosis Type 2 Diabetes about the Non Hypoglycemic Effect

Objective To investigate clinical curative effect of the Liraglutide in treatment of the not first diagnosis type 2 diabetes. Method Selected 100 patients of our hospital with type 2 diabetes who with poor blood sugar control by oral glucose-lowering drugs from January 2013 – June 2014, divided into observation group and control group（n=50 cases）,according to random number table method. The control group were given insulin, the observation group were given Liraglutide on the basis of the control group treatment, the observation time was 12 weeks.Observe the fasting blood glucose（FBG）, 2 h postprandial blood glucose（2hBG）, glycosylated hemoglobin（HbA1c）, fasting insulin（FINS）, insulin resistance index（HOMA-IR）, insulin sensitive index（WBISI）, triglycerides（TG）, cholesterol（TG）, high-density lipoprotein cholesterol（HDL- C）, low density lipoprotein cholesterol（LDL- C）, body mass index（BMI）, waist circumference（WC）, hip circumference（HC）, and systolic blood pressure（SBP）, diastolic blood pressure（DBP） of the two groups before and after treatment and record adverse reactions occur. Results The FBG, 2hBG, HbA1 c, FINS, HOMA-IR, WBISI, TC, TG, HDL-C, LDL-C, BMI, WC, HC, SBP, DBP of the two groups before treatment had no statistical significance differences（P〉 0.05）;The FBG, 2 hBG, HbA1 c of the two groups after treatment was obviously improved, with significant（P〈 0.05）,the differences of the two groups had no statistical significance（P 〉0.05）;The FINS, HOMA- IR, WBISI, BMI, WC, HC, TC, TG, HDL-C, LDL- C, SBP, DBP of the observation group after treatment was better than before treatment and the control group after treatment, differences has statistically significant（P〈 0.05）, the difference of the control group before and after treatment has no statistical significance（P〉 0.05）.Two groups of patients had no serious adverse reaction, the control group hypoglycemic events in 5 cases.Observation group gastrointestinal adverse re