论文部分内容阅读
目的观察利拉鲁肽对不同海拔地区糖调节受损肥胖患者内皮功能障碍的影响。方法选择经彩色多普勒检查血管内皮功能障碍的糖调节受损肥胖患者98例,按居住地海拔高度分为低海拔(1 780~2 999米)组(n=52)和高海拔(3 000~3 719米)组(n=46)。全部患者使用利拉鲁肽(起始剂量0.6 mg·d-1,皮下注射)治疗3个月,治疗前后检测血糖,血脂,血压,肝、肾功能等指标,使用全数字化高分辨率彩超测定肱动脉血管内皮依赖性舒张功能(FMD)。结果与治疗前比较,治疗后两组肝、肾功能,空腹血糖,餐后血糖,血脂,血压,腰臀比,糖化血红蛋白和C反应蛋白均有改善趋势,但无显著差异(P>0.05);两组空腹胰岛素和稳态胰岛素评价指数水平均显著下降(P<0.05),且低海拔组较高海拔组下降更为显著(P<0.05)。治疗后两组FMD均显著高于治疗前(P<0.05),且低海拔组高于高海拔组(P<0.05),低海拔组和高海拔组分别有28例(54%)和14例(30%)患者FMD转为正常,两组相比差异显著(P<0.05)。结论利拉鲁肽对不同海拔地区糖调节受损肥胖患者的血管内皮功能障碍及胰岛素抵抗均有不同程度的改善作用,且对低海拔地区患者改善作用更为显著。
Objective To observe the effects of liraglutide on endothelial dysfunction in obese patients with impaired glucose regulation at different altitudes. Methods Ninety-eight patients with impaired glucose regulation by vascular endothelial dysfunction were examined by color Doppler and divided into low altitude (1780-29999) group (n = 52) and high altitude (3 000 ~ 3 719 m) group (n = 46). All patients were treated with liraglutide (initial dose 0.6 mg · d-1, subcutaneously) for 3 months, and blood glucose, blood lipid, blood pressure, liver and renal function were measured before and after treatment. Brachial artery endothelium-dependent vasodilation (FMD). Results Compared with those before treatment, the liver and kidney function, fasting blood glucose, postprandial blood glucose, blood lipid, blood pressure, waist-hip ratio, glycosylated hemoglobin and C-reactive protein in both groups showed an improvement trend after treatment but no significant difference (P> 0.05) ; Both fasting insulin and steady state insulin index decreased significantly (P <0.05), and decreased more significantly in lower altitude group than in higher altitude group (P <0.05). After treatment, the FMD in both groups were significantly higher than those before treatment (P <0.05), and were higher in low-altitude group than in high-altitude group (P <0.05), and 28 (54%) and 14 (30%) patients with FMD turned normal, significant difference between the two groups (P <0.05). Conclusion Liraglutide can improve vascular endothelial dysfunction and insulin resistance to varying degrees in obese patients with impaired glucose regulation at different altitudes, and has a more significant effect on patients at low altitude.