摘要
目的探讨达格列净、利拉鲁肽对超重或肥胖2型糖尿病合并冠心病患者的糖脂代谢的影响。方法随机纳入2018年6月—2020年1月该院就诊的160例超重或肥胖2型糖尿病合并冠心病患者为研究对象,分两组,每组80例。所有患者均口服盐酸二甲双胍片(格华止)≥1500 mg/d,达格列净组启始予5 mg,根据血糖情况调整药物剂量,如空腹血糖>7.0 mmol/L,则达格列净加量至10 mg,1次/d。利拉鲁肽组起始予0.6 mg,当空腹血糖>7.0 mmol/L,则利拉鲁肽加量至1.2 mg。对比两组患者治疗前和治疗12周后的HbA1c,空腹血糖、餐后2 h血糖、胰岛功能、体重指数和不良反应等。结果从改善糖代谢角度,两组患者空腹血糖、餐后血糖和糖化血红蛋白等比较差异无统计学意义(P>0.05),但达格列净组的体重指数改善较利拉鲁肽组明显,差异有统计学意义(P<0.05)。从改善胰岛功能角度,治疗12周后,利拉鲁肽组的胰岛素抵抗指数明显低于达格列净,差异有统计学意义(P<0.05);从安全角度,两组患者低血糖等不良反应发生率差异无统计学意义(P>0.05)。结论两种药物治疗肥胖型2型糖尿病合并冠心病的效果相当,但在改善胰岛素抵抗,利拉鲁肽具有更明显的优势。
Objective To investigate the effects of dapagliflozin and liraglutide on glucose and lipid metabolism in overweight or obese patients with type 2 diabetes and coronary heart disease.Methods Randomly included 160 overweight or obese patients with type 2 diabetes and coronary heart disease who were treated from June 2018 to January 2020 at the hospital as the research objects,divided into two groups,each with 80 cases.All patients were given oral metformin hydrochloride tablets(Govazep)≥1500 mg/d,and the dapagliflozin group was given 5 mg at the beginning,and the dose of the drug was adjusted according to the blood glucose situation.If the fasting blood glucose>7.0 mmol/L,dapagliflozin should be increased to 10 mg,once a day.The liraglutide group was given 0.6 mg at the beginning.When the fasting blood glucose was greater than 7.0 mmol/L,the liraglutide was increased to 1.2 mg.The HbA1c,fasting blood glucose,2 h postprandial blood glucose,islet function,body mass index and adverse reactions before and after 12 weeks of treatment were compared between the two groups.Results From the perspective of improving glucose metabolism,there was no statistically significant difference in fasting blood glucose,postprandial blood glucose and glycosylated hemoglobin between the two groups of patients(P>0.05),but the body mass index of the dapagliflozin group was improved more than that of the liraglutide group,the difference was statistically significant(P<0.05).From the perspective of improving islet function,after 12 weeks of treatment,the insulin resistance index of the liraglutide group was significantly lower than that of dapagliflozin,the difference was statistically significant(P<0.05);from the perspective of safety,the incidence of adverse reactions such as hypoglycemia in the two groups was not obviously different,the difference was not statistically significant(P>0.05).Conclusion The two drugs have similar effects in treating obesity type 2 diabetes with coronary heart disease,but liraglutide has a more obvious advantage in improving insulin resistance.
作者
赖玉林
蔡填
王素妍
LAI Yu-lin;CAI Tian;WANG Su-yan(Department of Endocrinology,Huizhou Third People's Hospital,Huizhou,Guangdong Province,516008 China)
出处
《糖尿病新世界》
2021年第1期92-94,共3页
Diabetes New World Magazine
关键词
达格列净
利拉鲁肽
肥胖
2型糖尿病
冠心病患者
Dapagliflozin
Liraglutide
Obesity
Type 2 diabetes
Patients with coronary heart disease
作者简介
赖玉林(1987-),男,硕士,主治医师,研究方向为内分泌科常见疾病。
