海南医科大学学报

目的:探讨利拉鲁肽治疗2型糖尿病合并动脉粥样硬化的临床效果以及对患者血糖、血脂、血压和颈动脉斑块的影响。方法:选取2017年3月～2018年8月在本院接受治疗的82例2型糖尿病合并动脉粥样硬化患者为研究对象。采用随机数字表法分为对照组和观察组,每组各41例。所有患者均予以饮食运动干预,同时口服他汀类药物。在此基础上,对照组给予二甲双胍治疗,观察组给予利拉鲁肽治疗,两组均连续治疗6个月。观察两组患者治疗前后空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、收缩压(SBP)、舒张压(DBP)、体重指数(BMI)、体质量、腰围以及颈动脉斑块(软斑、扁平斑、硬斑、混合斑)等相关指标的变化,比较两组治疗疗效以及不良反应发生率。结果:观察组治疗总有效率大于对照组(χ²=4.232,P=0.040)。治疗后,观察组2hPG、HbA1c、FPG均低于同期对照组(t=2.315,8.803,5.445,P均<0.05);TG、TC、LDL-C均低于同期对照组(t=15.613,10.778,7.012,P均<0.05),而HDL-C高于同期对照组(t=4.545,P<0.05); SBP、DBP均低于同期对照组(t=3.254,2.159,P均<0.05);体质量、腰围和BMI均低于同期对照组(t=2.207,2.326,2.542,P均<0.05);IMT厚度低于同期对照组(t=2.116,P<0.05);斑块检出率低于对照组(χ²=4.895,P=0.027)。两组治疗期间不良反应发生率比较,差异无统计学意义(χ²=0.082,P=0.775)。结论:利拉鲁肽治疗2型糖尿病合并动脉粥样硬化的效果确切,在改善患者血糖、血脂、血压和控制体重方面具有明显优势,且不增加药物不良反应,值得临床推广应用。

Objective: To evaluate the clinical effect of Lilalutide in the treatment of type 2 diabetes mellitus with atherosclerosis and its effects on blood glucose, blood lipid, blood pressure and carotid plaque. Methods: 82 patients with type 2 diabetes complicated with atherosclerosis who were treated in our hospital from March 2017 to August 2018 were selected. The patients were randomly divided into control group and observation group with 41 cases in each group. All patients were given diet and exercise intervention and oral statins. On this basis, the control group was treated with metformin, the observation group was treated with Liraglutide, and the two groups were treated continuously for 6 months. The fasting blood glucose(FPG), postprandial blood glucose(2 hPG), glycosylated hemoglobin(HbA1 c), triglyceride(TG), total cholesterol(TC), high density lipoprotein(HDL-C), low density lipoprotein(LDL-C), systolic blood pressure(SBP), diastolic blood pressure(DBP), Body mass index(BMI), body mass, waist circumference, and carotid plaque(soft plaque, flat plaque, hard plaque, mixed plaque) were observed before and after treatment. The curative effect and the incidence of major adverse reactions between the two groups were compared. Results: The total effective rate of the observation group was higher than that of the control group(χ²=4.232, P=0.040). After treatment, the 2 hPG, HbA1 c and FPG in the observation group were lower than those in the control group(t=2.315, 8.803, 5.445,P<0.05); the TG, TC and LDL-C were lower than those in the control group(t=15.613, 10.778, 7.012,P<0.05), while HDL-C was higher than that in the control group(t=4.545,P<0.05); the SBP and DBP were lower than those in the control group(t=3.254, 2.159,P<0.05). the body mass, waist circumference and BMI were lower than those of control group(t=2.207, 2.326, 2.542,P<0.05); the IMT was lower than that in the control group(t=2.116,P<0.05); plaque detection rate was lower than that in the control group(χ²= 4.895,P=0.027). There was no significant difference in the incidence of adverse reactions between the two groups(χ² = 0.082, P=0.775). Conclusion: Liraglutide is effective in treating type 2 diabetes mellitus with atherosclerosis. It has obvious advantages in improving blood sugar, blood lipid, blood pressure and weight control, and does not increase adverse drug reactions. It is worthy of clinical application.