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目的探讨利拉鲁肽和门冬胰岛素30治疗2型糖尿病轻度认知损伤(MCI)的有效性、安全性及其对认知功能的影响和差异。方法 2型糖尿病MCI患者80例,随机分为两组,每组40例,胰岛素组维持原门冬胰岛素30治疗,利拉鲁肽组改为利拉鲁肽治疗,疗程均为48周。治疗前和治疗12、24、36、48周末测定患者血糖、血脂和血压水平,计算体重指数(BMI),进行蒙特利尔认知评估(MoCA)量表评分,并记录血糖达标[糖化血红蛋白(HbA_(1c))≤7%]、低血糖及痴呆发生情况。结果胰岛素组和利拉鲁肽组各完成39例和38例。治疗24、36周末,利拉鲁肽组三酰甘油水平显著低于胰岛素组(P<0.01),48周末HbA_(1c)水平低于胰岛素组(P<0.05),Mo CA量表评分高于胰岛素组(P<0.05)。胰岛素组和利拉鲁肽组血糖达标率分别为77%(30/39)和84%(32/38),痴呆发生率分别为5%(2/39)和0,差异均无显著意义(P>0.05);低血糖发生率分别为64%(25/39)和24%(9/38),利拉鲁肽组低于胰岛素组(P<0.01)。结论与门冬胰岛素30相比,利拉鲁肽治疗2型糖尿病MCI患者,可更好地控制HbA_(1c),低血糖发生率更低,并可改善患者认知功能。
Objective To investigate the efficacy and safety of liraglutide and insulin aspart 30 in the treatment of mild cognitive impairment (MCI) in type 2 diabetes mellitus (T2DM) and its influence on cognitive function. Methods Eighty patients with type 2 diabetes mellitus (MCI) were randomly divided into two groups (n = 40 in each group). The insulin group maintained the original aspart insulin level of 30 and the liraglutide group received liraglutide. The course of treatment was 48 weeks. Blood glucose, blood lipids and blood pressure were measured at 12, 24, 36 and 48 weeks before treatment and body mass index (BMI) were calculated. The Montreal Cognitive Assessment (MoCA) scale was scored and blood glucose compliance was recorded [HbA_ ( 1c)) ≤ 7%], hypoglycemia and dementia. Results The insulin group and liraglutide group completed 39 cases and 38 cases. Treated for 24 and 36 weeks, the triglyceride level in liraglutide group was significantly lower than that in insulin group (P <0.01), the level of HbA 1c in 48th week was lower than that in insulin group (P <0.05) Insulin group (P <0.05). The rates of blood glucose compliance in insulin group and liraglutide group were 77% (30/39) and 84% (32/38) respectively, and the incidence of dementia was 5% (2/39) and 0 respectively, with no significant difference P> 0.05). The incidence of hypoglycemia was 64% (25/39) and 24% (9/38), respectively. The liraglutide group was lower than the insulin group (P <0.01). Conclusion Liraglutide is better able to control HbA 1c in patients with type 2 diabetes mellitus than in insulin aspart 30, with a lower incidence of hypoglycemia and improved cognitive function.