论文部分内容阅读
对2019年4—10月滁州市第一人民医院内分泌科诊断为2型糖尿病行口服二甲双胍（2.0 g/d）治疗3个月以上血糖仍不达标的124例患者，采用随机数字表分组法分为口服药组和利拉鲁肽组，各62例。口服药组在二甲双胍基础上联合阿卡波糖（300 mg/d）治疗，利拉鲁肽组在二甲双胍基础上联合利拉鲁肽治疗（1.2 mg/d），疗程均12周。观察两组治疗前、后体重、空腹血糖、餐后2 h血糖（2 hPG） 、糖化血红蛋白（HbA1c）、总胆固醇（TC）及甘油三酯水平，以及消化道症状和低血糖发生情况。治疗12周后，两组患者体重、空腹血糖、2 hPG、HbA1c均较治疗前下降（均n P<0.05）；与口服药组相比，利拉鲁肽组患者体重、空腹血糖、2 hPG、HbA1c和甘油三酯水平下降程度［（4.24±1.04）kg、（3.38±0.72） mmol/L、（5.36±0.86） mmol/L、（2.43±0.98）%、（1.25±0.33） mmol/L］均高于口服药组［（0.62±0.23）kg、（2.09±0.46）mmol/L、（3.62±1.03）mmol/L、（1.17±0.36）%、（0.60±0.24）mmol/L，均n P<0.05］；利拉鲁肽组出现轻、中度胃肠道反应，分别为17例恶心、5例呕吐、4例腹泻，口服药组41例腹胀、1例腹泻；两组均无低血糖发生。提示利拉鲁肽联合二甲双胍可显著改善2型糖尿病患者的血糖、血脂、体重，且无低血糖发生。n “,”One hundred and twenty four patients with type 2 diabetes mellitus (T2DM) admitted to the Department of Endocrinology of Chuzhou First People's Hospital from April to October 2019 whose blood glucose levels were not controlled after treatment with metformin (2.0 g/d) for more than 3 months were enrolled in the study. The patients were randomly divided into oral drug group and liraglutide group with 62 cases in each group. On the basis of metformin, the oral drug group was treated with acarbose (300 mg/d); the liraglutide group was treated with liraglutide (1.2 mg/d). The course of treatment was 3 months. The body weight, fasting blood glucose (FPG), 2-h postprandial blood glucose (2 hPG), glycosylated hemoglobin (HbA1c), cholesterol (TC) and triglyceride (TG) levels were compared between the two groups before and after treatment, and the gastrointestinal symptoms and the incidence of hypoglycemia were analyzed. After 3-month treatment the body weight, FPG, 2 hPG, HbA1c of the two groups were lower than the baseline levels (n P<0.05). Compared with the oral group, the body weight, FPG, 2 hPG, HbA1c and TG in liraglutide group were more markedly decreased (n P<0.05). The gastrointestinal reaction of liraglutide group was significantly higher than that of the oral drug group, and there was no hypoglycemia in both groups. The data indicate that liraglutide combined with metformin can significantly improve the blood glucose, blood lipid and body weight of T2DM patients and no hypoglycemia occurs during the treatment.n