利拉鲁肽与二甲双胍合用对超重2型糖尿病患者代谢指标影响.docVIP

利拉鲁肽与二甲双胍合用对超重2型糖尿病患者代谢指标影响 　　[摘要] 目的 观察利拉鲁肽与二甲双胍合用对超重的2型糖尿病患者代谢指标的影响。 方法 选取40例经二甲双胍口服治疗3个月但血糖仍未达标的合并体重超重的2型糖尿病患者，给予联合利拉鲁肽治疗12周，检测并分析血糖及其他相关指标变化。 结果 12周后，患者腹围较前下降，但差异无统计学意义（P0.05）；患者体重、体重指数、空腹血糖、胰岛素抵抗指数HOMA-IR、糖化血红蛋白、低密度脂蛋白胆固醇水平较前下降，差异具有统计学意义（P0.05）；胰岛β细胞功能指数HOMA-β升高，差异具有统计学意义（P0.05）。联合治疗期间无严重低血糖事件发生。 结论 对于合并超重的2型糖尿病患者，利拉鲁肽联合二甲双胍治疗安全有效，且对体重指数、胰岛素抵抗指数HOMA-IR、胰岛β细胞功能指数HOMA-β、糖化血红蛋白、血脂等代谢指标均有明显改善作用。 　　[关键词] 利拉鲁肽；二甲双胍；2型糖尿病 　　[中图分类号] R587.1 [文献标识码] B [文章编号] 2095-0616（2015）17-96-03 　　Clinical efficacy of liraglutide combined with metformin in the treatment of obesity type 2 diabetes 　　LI Shanshan1 SUN Jian2 　　1.Guiyang University of Traditional Chinese Medicine，Guiyang 550002，China； 2.Depatment of Endocrinology，the Second Affiliated Hospital of Baotou Medical University，Baotou 014030，China 　　[Abstract] Objective To study the therapeutic effects of the combination of Liraglutide and Metformin on obesity patients with type 2 diabetes（T2DM）. Methods 40 obesity patients with type 2 diabetes whose blood glucose were not well controlled by taking oral metformin 3 months，given liraglutide and metformin therapy for 3 months.To explore abdomen circumference，the levels of fasting blood glucose，2h postprandial blood glucose，glycosylated hemoglobin，blood fat after treatment for 12 weeks. Results After 3 months treatment，HbA1c，FPG，2 hPG，HOMA-IR，low density lipoprotein cholesterol and BMI were reduced （P0.05）.HOMA-β were increased（P0.05）.Minority patients had nausea and discomfort of gastrointestinal symptoms within endurance. Conclusion Combination of liraglutide and metformin can significantly decrease blood glucose，reduce weight gain and serum lipid，improve insulin function which is a safe and effective therapy strategy for fatty type 2 diabetic patients. 　　[Key words] Liraglutide；Obesity；Type 2 diabetes mellitus 　　2型糖尿病患者常常伴有血脂紊乱、非酒精性脂肪肝及肥胖等代谢紊乱，肥胖的2型糖尿病患者胰岛素抵抗明显，血糖经治疗后仍较难达标，良好的控制血糖是糖尿病治疗的关键环节，而监测HbAlc对糖尿病血糖控制、疗效判定及调整治疗的有重要意义[1-2]。作为糖尿病药物治疗中经典的药物，二甲双胍可以有效的增加胰岛素敏感性，减轻胰岛素抵