CAJ | 학술논문

目的：观察利拉鲁肽对多种口服降糖药物联用并和胰岛素联合治疗疗效不佳的肥胖2型糖尿病患者的临床疗效和安全性。方法选择对多种口服降糖药物联用并和胰岛素联合治疗疗效不佳的肥胖2型糖尿病患者21例，在原有治疗基础上加用利拉鲁肽治疗12周。观察比较治疗前后的空腹血糖(FBG)、餐后2 h血糖(2 hPBG)、糖化血红蛋白(HbA1c)、体重指数(BMI)、血脂、血压、空腹胰岛素（FIns）、稳态模型胰岛素抵抗指数(HOMA-IR)、稳态模型胰岛β细胞分泌指数(HOMA-β)、胰岛素使用量及不良反应等指标。结果加用利拉鲁肽治疗12周后，患者的FBG、2 hPBG、HbA1c、TG、BMI、FIns、HOMA-IR、胰岛素用量均明显下降，差异有统计学意义(P<0.05)。治疗后的HOMA-β与治疗前比较明显升高，差异有统计学意义(P<0.05)。主要的不良反应为胃肠道反应及低血糖，但两者均较轻微且短暂。结论对多种口服降糖药物联用且和胰岛素联合治疗后血糖仍控制欠佳的肥胖2型糖尿病患者，利拉鲁肽可有效控制血糖，改善胰岛素抵抗，提高胰岛素敏感性，增强胰岛β细胞功能。
목적：관찰리랍로태대다충구복강당약물련용병화이도소연합치료료효불가적비반2형당뇨병환자적림상료효화안전성。방법선택대다충구복강당약물련용병화이도소연합치료료효불가적비반2형당뇨병환자21례，재원유치료기출상가용리랍로태치료12주。관찰비교치료전후적공복혈당(FBG)、찬후2 h혈당(2 hPBG)、당화혈홍단백(HbA1c)、체중지수(BMI)、혈지、혈압、공복이도소（FIns）、은태모형이도소저항지수(HOMA-IR)、은태모형이도β세포분비지수(HOMA-β)、이도소사용량급불량반응등지표。결과가용리랍로태치료12주후，환자적FBG、2 hPBG、HbA1c、TG、BMI、FIns、HOMA-IR、이도소용량균명현하강，차이유통계학의의(P<0.05)。치료후적HOMA-β여치료전비교명현승고，차이유통계학의의(P<0.05)。주요적불량반응위위장도반응급저혈당，단량자균교경미차단잠。결론대다충구복강당약물련용차화이도소연합치료후혈당잉공제흠가적비반2형당뇨병환자，리랍로태가유효공제혈당，개선이도소저항，제고이도소민감성，증강이도β세포공능。
Objective To observe the clinical efficacy and safety of liraglutide on obese type 2 diabetes pa-tients with resistant to combinations of oral hypoglycemic drugs and insulin. Methods Twenty one obese type 2 dia-betic patients with resistant to combinations of oral hypoglycemic drugs and insulin were investigated. Liraglutide were added to the original treatment strategy for 12 weeks and its effects were observed on fasting blood glucose (FBG), 2h postprandial blood glucose (2hPBG), glycosylated hemoglobin (HbA1c), body mass index (BMI), blood lip-ids, blood pressure, fasting insulin (FIns), homeostasis model assessment of insulin resistance index (HOMA-IR), ho-meostasis model assessment index of pancreatic β cell secretion (HOMA-β), insulin dosage and adverse reactions. Results The patient's FBG, 2hPBG, HbA1c, TG, BMI, FIns, HOMA-IR, and insulin dosage decreased significant-ly after 12 weeks of treatment with Liraglutide (P<0.05). HOMA-β increased remarkably after Liraglutide treat-ment (P<0.05). The main adverse reactions were gastrointestinal reactions and low blood sugar, both of which were mild and transient. Conclusion For obese type 2 diabetic patients with poorly controlled blood glucose even underwent combination therapy of multiple oral hypoglycemic drugs and insulin, liraglutide can effectively control blood sugar, improve insulin resistance and insulin sensitivity, and enhance isletβcells function.