CAJ | 학술논문

目的观察利拉鲁肽治疗超重或肥胖2型糖尿病患者的临床疗效、不良反应和依从性.方法 93例超重或肥胖2型糖尿病患者在原治疗基础上皮下注射利拉鲁肽0.6 mg/d,逐渐加量至1.2 ～1.8 mg/d,于1,4,12,54周随访利拉鲁肽对体重、血糖、原治疗方案的影响,记录不良反应和停药情况.结果治疗1周后即有32.2％(29/90)的患者体重下降,治疗54周后8例患者体重由(86.50±11.66)kg降至(83.13±10.88)kg(t=3.32,P＜0.05)；治疗12周后43例患者1,4,12周体重与0周相比均明显下降(P＜0.01)；利拉鲁肽注射3d后空腹和餐后血糖即明显下降(t分别为4.30、6.90,P均＜0.01)并保持继续下降至12周(t分别为4.58、6.71,P均＜0.01)；在治疗12周后24例联合胰岛素治疗的患者中胰岛素停用和减量者达83.3％ (20/24),仅2例与胰岛素联合使用时发生轻微低血糖.主要不良反应为厌食、恶心、呕吐、腹泻,以厌食最为常见,在4周内全部缓解,恶心、腹泻于5d内消失.23.7％(22/93)的患者因费用原因停用利拉鲁肽,占68.2％(15/22).结论利拉鲁肽具有良好和迅速的减重、降糖作用,不良反应以胃肠道症状为主,为一过性,低血糖发生率低.
목적 관찰리랍로태치료초중혹비반2형당뇨병환자적림상료효、불량반응화의종성.방법 93례초중혹비반2형당뇨병환자재원치료기출상피하주사리랍로태0.6 mg/d,축점가량지1.2 ～1.8 mg/d,우1,4,12,54주수방리랍로태대체중、혈당、원치료방안적영향,기록불량반응화정약정황.결과 치료1주후즉유32.2％(29/90)적환자체중하강,치료54주후8례환자체중유(86.50±11.66)kg강지(83.13±10.88)kg(t=3.32,P＜0.05)；치료12주후43례환자1,4,12주체중여0주상비균명현하강(P＜0.01)；리랍로태주사3d후공복화찬후혈당즉명현하강(t분별위4.30、6.90,P균＜0.01)병보지계속하강지12주(t분별위4.58、6.71,P균＜0.01)；재치료12주후24례연합이도소치료적환자중이도소정용화감량자체83.3％ (20/24),부2례여이도소연합사용시발생경미저혈당.주요불량반응위염식、악심、구토、복사,이염식최위상견,재4주내전부완해,악심、복사우5d내소실.23.7％(22/93)적환자인비용원인정용리랍로태,점68.2％(15/22).결론 리랍로태구유량호화신속적감중、강당작용,불량반응이위장도증상위주,위일과성,저혈당발생솔저.
Objective To observe the clinical effects,adverse effects and compliance of liraglutide for overweight or obese patients with type 2 diabetes mellitus (T2DM).Methods 93 overweight or obese patients with T2DM treated by subcutaneous injection of liraglutide 0.6 mg per day and original treatment.The dosage of liraglutide was increased to 1.2 or 1.8 mg per day gradually.The effects of liraglutide on weight,blood glucose,original treatments were followed up,adverse effects and drug withdrawal were recorded in the first,fourth,twelfth and fifty-fourth weeks.Results After the treatment of one week,32.2％ (22/90)of the patients lost weight.Eight patients lost weight from (86.50 ± 11.66) kg to (83.13 ± 10.88) kg (t =3.32,P ＜0.05)after 54 weeks of the treatment.The body weights of 43 patients after 12 weeks of the treatment decreased significantly compared with baseline(P ＜ 0.01).After 3 days of the injection of liraglutide,the fasting and postprandial blood glucose decreased obviously (t =4.30,6.90 respectively,all P ＜ 0.01),and kept decreasing to the twelfth week(t =4.58,6.71 respectively,all P ＜0.01).83.3％ (20/24) of the 24 patients who combined with insulin discontinued or decreased the dosage of insulin after 12 weeks and only two of them happened with slight hypoglycemia reaction.The main adverse effects were anorexia,nausea,vomiting,diarrhea and anorexia was most common.All of these were in remission in 4 weeks and nausea disappeared in 5 days as well as diarrhea.23.7％ (22/93) of the patients stopped liraglutide mostly because of the cost,it made up about 68.2％ (15/22).Conclusions Liraglutide can lose weight and reduce blood glucose effectively and rapidly.The main adverse effect is gastrointestinal reaction and is transient.The incidence rate of hypoglycemia is very low with liraglutide.