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中华肥胖与代谢病电子杂志

中华肥胖与代谢病电子杂志 ›› 2020, Vol. 06 ›› Issue (03) : 185 -190. doi: 10.3877/cma.j.issn.2095-9605.2020.03.009

所属专题： 文献；

论著

利拉鲁肽联合胰岛素泵对2型糖尿病伴代谢综合征患者代谢指标的影响
吴跃冠1,†(), 赵凡1, 邓素荣1   
  1. 1. 529000　江门，江门市人民医院内分泌科
  • 收稿日期:2020-05-26 出版日期:2020-08-30
  • 通信作者: 吴跃冠
  • 基金资助:
    2019年度江门市医疗卫生科技计划项目(江科【2019】101)

Impact of Lylalutide combined with insulin pump on metabolic indicators in patients with type 2 diabetes mellitus and metabolic syndrome

Yueguan Wu1,†(), Fan Zhao1, Surong Deng1   

  1. 1. Department of Endocrinology, Jiangmen People's Hospital, Jiangmen 529000, China
  • Received:2020-05-26 Published:2020-08-30
  • Corresponding author: Yueguan Wu
  • About author:
    Corresponding author: Wu Yueguan, Email:
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吴跃冠, 赵凡, 邓素荣. 利拉鲁肽联合胰岛素泵对2型糖尿病伴代谢综合征患者代谢指标的影响[J/OL]. 中华肥胖与代谢病电子杂志, 2020, 06(03): 185-190.

Yueguan Wu, Fan Zhao, Surong Deng. Impact of Lylalutide combined with insulin pump on metabolic indicators in patients with type 2 diabetes mellitus and metabolic syndrome[J/OL]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2020, 06(03): 185-190.

目的

探讨利拉鲁肽联合胰岛素泵对2型糖尿病（T2DM）伴代谢综合征（MetS）患者的临床疗效及代谢指标的影响。

方法

选择2019年1月至2020年2月于江门市人民医院接受治疗的2型糖尿病伴MetS患者共60例，随机分为联合组和对照，其中联合组采用利拉鲁肽联合胰岛素泵治疗，对照组采用胰岛素泵治疗，比较两组患者的入院时及治疗2周、12周后的体质指标，以及血糖、糖化血红蛋白（HbA1c）及总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇（HDL-C）水平。

结果

两组患者治疗前的平均BMI、腰围、血压水平对比差异无统计学意义（P>0.05），治疗12周联合组的BMI和腰围水平显著低于治疗前，且低于对照组（P<0.05），两组患者治疗前的空腹和餐后2h的血糖水平，C肽水平和HbA1c对比差异无统计学意义（P>0.05），联合组的C肽水平在治疗2周、12周时显著高于对照组（P<0.05），且联合组的HbA1c水平在治疗2周、12周时显著低于对照组（P<0.05），两组患者治疗前的平均TC、TG、LDL-C、HDL-C水平对比差异无统计学意义（P>0.05），联合组在干预2周时的TC、LDL-C水平及干预12周时的TC、TG、LDL-C水平均显著低于对照组，而HDL-C水平显著高于对照组，差异具有统计学意义（P<0.05）。

结论

利拉鲁肽联合胰岛素泵可以有效改善T2DM合并MetS患者的体重，提高血糖控制效果，并改善血脂水平。

关键词: 利拉鲁肽, 胰岛素泵, 2型糖尿病, 代谢综合征, 血脂
Objective

To explore the effect of liraglutide combined with insulin pump on the clinical efficacy and metabolic indexes of patients with type 2 diabetes and metabolic syndrome.

Methods

A total of 60 patients with type 2 diabetes and MetS treated in our hospital from January 2019 to February 2020 were selected and randomly divided into a combined group and a control group. The combined group was treated with liraglutide combined with insulin pump. The control group was treated with an insulin pump, and the BMI, waist circumference, blood pressure, blood glucose, glycated hemoglobin (HbA1c), and blood lipids (Total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) were compared between the two groups at the time of admission and after 2 and 12 weeks of treatment.

Results

There was no statistically significant difference in the average BMI, waist circumference and blood pressure before treatment between the two groups of patients (P>0.05). The BMI and waist circumference of the combined group after 12 weeks of treatment were significantly lower than before treatment and lower than the control group (P<0.05), the blood glucose level before treatment in both groups of patients, including fasting and 2h postprandial blood glucose levels, C peptide level and HbA1c difference was not statistically significant (P>0.05), the combination group C peptide level in treatment 2 Weeks and 12 weeks were significantly higher than the control group (P<0.05), and the HbA1c level of the combined group was significantly lower than the control group at 2 and 12 weeks of treatment (P<0.05). There was no significant difference in the average TC, TG, LDL-C, HDL-C levels between the two groups of patients before treatment (P>0.05). The levels of TC, TG and LDL-C were significantly lower than those of the control group, while the levels of HDL-C were significantly higher than that of the control group (P<0.05) .

Conclusions

In the perioperative period of weight loss and metabolic surgery, the implementation of rapid rehabilitation measures is superior to the traditional mode, which can significantly shorten the time of hospitalization, reduce postoperative complications, rapid recovery and save cost, and has outstanding application value.

Key words: Liraglutide, Insulin pump, Type 2 diabetes, Metabolic syndrome, Blood lipids
表1 两组患者一般资料比较
组别 N（例） 年龄（岁） 性别（男/女） 高血压（%） 冠心病（%） 吸烟（%） 病程（年）
联合组 30 52.4±4.3 18/12 22(47.9) 4(47.9) 6(14.7) 5.6±1.4
对照组 30 51.9±4.8 20/10 23(40.2) 5(40.2) 5(12.7) 5.7±1.9
t/χ2值 ? 0.425 0.287 0.089 0.131 0.111 0.232
P值 ? 0.672 0.592 0.766 0.718 0.739 0.817
表2 两组患者不同时间的体质指标对比
组别 N（例） BMI（kg/m2） 腰围（cm） 血压(mmHg)
收缩压 舒张压
联合组 30 ? ? ? ?
? 治疗前 ? 29.4±2.7 104.5±4.8 157±14 94±12
? 治疗后2周 ? 28.6±2.9 101.6±4.5* 155±14 92±13
? 治疗后12周 ? 27.4±2.1*# 97.3±3.9*# 151±13 91±12
对照组 30 ? ? ? ?
? 治疗前 ? 29.2±2.8 105.1±4.8 159±17 96±16
? 治疗后2周 ? 29.1±2.6 105.0±4.7 156±15 95±14
? 治疗后12周 ? 28.8±2.5 104.8±4.5 155±14 94±15
表3 两组患者不同时间的血糖相关指标对比
组别 N（例） 血糖（mmol/L） C肽（ng/ml） HbA1c（%）
空腹 餐后2 h
联合组 30 ? ? ? ?
? 治疗前 ? 8.6±1.8 14.7±3.2 1.7±0.5 8.7±0.9
? 治疗后2周 ? 7.3±1.4* 9.5±2.8* 2.4±0.4*# 7.8±0.5*#
? 治疗后12周 ? 6.9±1.3* 8.4±1.9* 2.9±0.5*# 6.6±0.4*#
对照组 30 ? ? ? ?
? 治疗前 ? 8.8±1.6 14.9±3.0 1.6±0.4 8.8±0.8
? 治疗后2周 ? 7.5±1.5* 9.8±2.4* 1.7±0.5 8.2±0.6*
? 治疗后12周 ? 7.1±1.4* 8.5±1.6* 1.8±0.5 7.4±0.5*
表4 两组患者不同时间的血脂相关指标对比
组别 N（例） TC（mmol/L） TG（mmol/L） LDL-C（mmol/L） HDL-C（mmol/L）
联合组 30 ? ? ? ?
? 治疗前 ? 5.14±0.73 3.23±0.41 3.35±0.45 0.86±0.15
? 治疗后2周 ? 4.72±0.54*# 3.02±0.37* 3.14±0.34*# 1.03±0.12*#
? 治疗后12周 ? 4.26±0.73*# 2.52±0.33*# 2.76±0.29*# 1.24±0.17*#
对照组 30 ? ? ? ?
? 治疗前 ? 5.18±0.71 3.25±0.44 3.39±0.41 0.87±0.14
? 治疗后2周 ? 5.05±0.65 3.19±0.42 3.35±0.42 0.90±0.11
? 治疗后12周 ? 4.85±0.67* 2.87±0.34* 3.14±0.27* 0.91±0.13
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