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目的:探讨艾塞那肽对肥胖及超重的中青年2型糖尿病患者体质量、血糖、血脂、血同型半胱氨酸及蛋白尿的影响,为临床上更好地控制该类患者的大血管及微血管并发症提供依据。方法:选取口服降糖药治疗不达标的肥胖及超重中青年2型糖尿病患者60例,随机分为艾塞那肽组(n=30)和诺和灵N组(n=30),在维持原口服降糖药基础上,分别加用艾塞那肽和精蛋白生物合成人胰岛素(诺和灵N),疗程均为3个月。比较两组患者治疗前后的体质量、体质指数(BMI)、空腹血糖(FPG)、餐后2h血糖(2h PG)、糖化血红蛋白(HbA1c)、空腹C肽(FCP)、餐后2hC肽(2hCP)、血脂、同型半胱氨酸(HCY)及尿微量白蛋白(UMA)等水平的变化。结果:治疗3个月后,两组FPG、2h PG、HbA1c等指标均较治疗前明显下降(P<0.05),且两组间相比无显著差异(P>0.05)。艾塞那肽组患者的FCP、2hCP较治疗前升高(P<0.05),体质量、BMI、TG、UMA均较治疗前显著下降(P<0.05),且均明显优于诺和灵N组(P<0.05);而诺和灵N组上述指标治疗前后无明显差异(P>0.05)。结论:艾塞那肽能有效控制血糖,并且可明显减重、改善胰岛功能、降低血脂、降低尿蛋白。
Objective: To investigate the effect of exenatide on body weight, blood glucose, blood lipids, blood homocysteine and proteinuria in obese and overweight young patients with type 2 diabetes mellitus, so as to better control the large blood vessels of these patients clinically And microvascular complications provide the basis. Methods: A total of 60 obese and overweight middle-aged patients with type 2 diabetes who did not meet the standard of oral hypoglycemic agents were randomly divided into exenatide group (n = 30) and noradrenon N group (n = 30) On the basis of the original oral hypoglycemic agents, exenatide and protamine biosynthesis of human insulin (norepinephrine N) were added respectively for 3 months. Body mass, body mass index (BMI), fasting blood glucose (FPG), postprandial 2h blood glucose (HbA1c), fasting C peptide (FCP), postprandial 2hC peptide ), Blood lipid, homocysteine (HCY) and urinary microalbumin (UMA) were measured. Results: After 3 months of treatment, the indexes of FPG, 2h PG and HbA1c in two groups were significantly lower than those before treatment (P <0.05), and there was no significant difference between the two groups (P> 0.05). Exenatide group FCP, 2hCP than before treatment increased (P <0.05), body weight, BMI, TG, UMA were significantly lower than before treatment (P lt; 0.05), and were significantly superior to norepinephrine N (P <0.05). No significant difference was found between the above indexes of Noroxen N before and after treatment (P> 0.05). Conclusion: Exenatide can effectively control blood sugar, and can significantly reduce weight, improve islet function, lower blood lipids, reduce urinary protein.