罗晶,
梁琳琅^,,
孔媛,
杨昕
北部战区总医院 内分泌科，辽宁 沈阳 110016

详细信息 作者简介: 罗 晶（1974-），女，副主任医师。E-mail：1541624362@qq.com




通讯作者: 梁琳琅，主任医师。E-mail：lianglllj@sina.com 中图分类号: R587.1


摘要:目的分析达格列净联合利拉鲁肽强化降糖治疗对2型糖尿病患者的疗效及对胰岛素抵抗、游离脂肪酸（FFA）和内皮素（ET）的影响。方法选取2020年6月至2022年6月某战区医院收治的2型糖尿病患者92例，所有患者既往均曾有过二甲双胍或二甲双胍联合磺脲类药物降糖不佳治疗史，应用随机数字表法将其分为A组及B组，各46例。A组患者给予达格列净单药治疗，B组患者在达格列净基础上联合利拉鲁肽治疗，两组患者均持续治疗3个月；记录并比较两组患者治疗前后血糖水平［空腹血糖（FPG）、餐后2 h血糖（2h-PBG）、糖化血红蛋白（HbA1c）］、胰岛功能［胰岛素抵抗指数（HOMA-IR）和胰岛β细胞功能指数（HOMA-β）］、血浆FFA及ET-1水平的差异，同时评价两组患者临床疗效及药物不良反应发生情况。结果B组治疗的总有效率95.65%（44例）显著高于A组82.62%（38例）（P＜0.05）。治疗后，FPG、2h-PBG、HbA1c、FFA、ET-1水平及HOMA-IR均显著低于治疗前，且B组各指标均低于A组（P均＜0.05）；患者的HOMA-β均显著高于治疗前，且B组高于A组（P＜0.05）；两组不良反应发生情况比较，差异无统计学意义（P＞0.05）。结论达格列净联合利拉鲁肽强化降糖的疗效确切，能够有效控制血糖水平，改善胰岛功能，同时具有调控FFA及ET-1水平的功效，不良反应发生率低，值得临床推广。
关键词: 2型糖尿病/
达格列净/
利拉鲁肽/
联合治疗/
胰岛功能


Abstract:ObjectiveTo analyze the effect of Dapagliflozin combined with Liraglutide in the treatment of type 2 diabetes and the influence on insulin resistance, plasma free fatty acid (FFA) and endothelin-1 (ET-1).MethodsFrom June 2020 to June 2022, 92 patients with type 2 diabetes, who were definitely diagnosed in our hospital, were selected as the study subjects. All patients had a history of poor response to the treatment of metformin or metformin combined with sulfonylureas in the past. They were divided into group A and group B with 46 cases each by random number table. Group A patients were treated with Dapagliflozin alone, while group B patients were treated with combination therapy with Liraglutide on the basis of group A. Both groups of patients received continuous treatment for 3 months. The blood glucose levels [fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2h-PBG) and glycated hemoglobin (HbA1c)], islet functions [insulin resistance index (HOMA-IR) and β cellular function index (HOMA-β)], FFA and ET-1 levels were measured and compared between two groups of patients before and after treatment, and the clinical efficacy and incidence of adverse drug reactions were evaluated.ResultsThe therapeutic response in group B patients were significantly better than group A in terms of blood glucose levels and islet function (P＜0.05). The levels of FPG, 2h-PBG, HbA1c, FFA, ET-1, and HOMA-IR after treatment in the two groups of patients were significantly lower than those before treatment, and the decreases in group B were significantly greater than those in group A (P＜0.05). HOMA-β after treatment in both groups A and B was significantly higher than that before treatment, and the increase in group B was significantly greater than that in group A (P＜0.05). In terms of adverse reaction comparison, there was no significant difference between group A and group B (P＞0.05).ConclusionThe combination of Dapagliflozin and Liraglutide has a definite therapeutic effect on type 2 diabetic patients, which can effectively control blood sugar levels, improve pancreatic islet function, and regulate FFA and ET-1 levels. Moreover, the incidence of adverse reactions is low, and it is worthy of clinical promotion.
Keywords:type 2 diabetes/
Dapagliflozin/
Liraglutide/
combination therapy/
islet function

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