摘要
目的探讨利拉鲁肽联合吡格列酮对肥胖型2型糖尿病(T2DM)患者糖脂代谢、血管内皮功能、血糖波动程度的影响。方法选取2017年4月至2020年8月我院收治的69例肥胖型T2DM患者作为研究对象,根据用药方案不同将其分为对照组(n=34)和观察组(n=35)。对照组采用常规治疗+吡格列酮,观察组在对照组基础上加用利拉鲁肽。比较两组治疗前、后的糖脂代谢指标、血管内皮功能指标、血糖波动指标、腰围(WC)、内脏脂肪面积(VFA)、身体质量指数(BMI)。结果治疗后,两组患者的三酰甘油(TG)、总胆固醇(TC)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)水平均较治疗前降低,且观察组显著低于对照组,差异具有统计学意义(P<0.05)。治疗后,两组患者的内皮素1(ET-1)水平较治疗前降低,一氧化氮(NO)水平较治疗前升高,且观察组的ET-1水平显著低于对照组,NO水平显著高于对照组,差异具有统计学意义(P<0.05)。治疗后,两组患者的平均血糖波动幅度(MAGE)、日间血糖平均绝对值(MODD)均较治疗前降低,且观察组显著低于对照组,差异具有统计学意义(P<0.05)。治疗后,两组患者的WC、VFA、BMI均较治疗前减小,且观察组显著小于对照组,差异具有统计学意义(P<0.05)。结论利拉鲁肽联合吡格列酮可改善肥胖型T2DM患者的糖脂代谢与血管内皮功能,控制血糖波动程度与体重,减少VFA,值得推广。
Objective To explore the effects of liraglutide combined with pioglitazone on glucose and lipid metabolism,vascular endothelial function and degree of blood glucose fluctuation in obese patients with type 2 diabetes mellitus(T2 DM).Methods A total of 69 obese T2 DM patients admitted to our hospital from April 2017 to August 2020 were selected as the study objects.According to different medication schemes,the patients were divided into control group(n=34) and observation group(n =35).The control group was treated with routine treatment + pioglitazone,and the observation group was treated with liraglutide on the basis of the control group.The glucose and lipid metabolism indexes,vascular endothelial function indexes,blood glucose fluctuation indexes,waist circumference(WC),visceral fat area(VFA) and body mass index(BMI) before and after treatment were compared between the two groups.Results After treatment,the levels of triacylglycerol(TG),total cholesterol(TC),fasting plasma glucose(FPG) and 2 h postprandial blood glucose(2 h PG) in the two groups decreased compared with those before treatment,those in the observation group were significantly lower than the control group,and the differences were statistically significant(P<0.05).After treatment,the level of endothelin-1(ET-1) decreased and the level of nitric oxide(NO) increased in the two groups compared with those before treatment,the level of ET-1 in observation group was significantly lower than that in the control group,the level of NO was significantly higher than that in the control group,and the differences were statistically significant(P <0.05).After treatment,the mean amplitude of glycemic excuisions(MAGE) and absolute mean of daily difference(MODD) of blood glucose in the two groups were lower than those before treatment,those in the observation group were significantly lower than the control group,and the differences were statistically significant(P<0.05).After treatment,WC,VFA and BMI in the two groups decreased compared with those before treatment,those in the observation group were significantly lower than the control group,and the differences were statistically significant(P <0.05).Conclusion Liraglutide combined with pioglitazone can improve glucose and lipid metabolism and vascular endothelial function in obese T2 DM patients,control the degree of blood glucose fluctuation and weight,and reduce VFA,which is worthy of promotion.
作者
高琳
张杨
GAO Lin;ZHANG Yang(Baoji Central Hospital,Baoji 721008,China)
出处
《临床医学研究与实践》
2022年第1期46-49,共4页
Clinical Research and Practice
关键词
利拉鲁肽
吡格列酮
肥胖
2型糖尿病
糖脂代谢
血管内皮功能
血糖波动
liraglutide
pioglitazone
obesity
type 2 diabetes mellitus
glucose and lipid metabolism
vascular endothelial function
blood glucose fluctuation
