CAJ | 학술논문

目的：探讨利拉鲁肽联合经鼻持续气道正压通气（nCPAP）治疗阻塞性睡眠呼吸暂停低通气综合征（OSAHS）伴肥胖的早发2型糖尿病的临床疗效及安全性。方法将20例患者随机分为对照组和观察组，各10例。两组患者均予nCPAP治疗，对照组患者在此基础上加服二甲双胍，每次850 mg，3次/日；观察组患者则联合皮下注射利拉鲁肽，第1周0.6 mg/d，第2周1.2 mg/d，共治疗12周。观察患者体重指数（BMI）、空腹血糖（FPG）、餐后2小时血糖（2 h PG）、糖化血红蛋白（HbA1C）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA－IR）、血脂、呼吸暂停－低通气指数（AHI）、最低血氧饱和度（LSpO2）的变化。结果治疗12周后，两组患者的 FPG，2 h PG，HbA1C，FINS， HOMA－IR、三酰甘油（TG）及AHI均较治疗前显著下降，LSpO2较治疗前显著上升（ P<0.05）；与对照组相比，观察组各项指标改善更明显（ P<0.05）。结论利拉鲁肽联合nCPAP治疗OSAHS伴肥胖的早发2型糖尿病，疗效及安全性均优于二甲双胍。
목적：탐토리랍로태연합경비지속기도정압통기（nCPAP）치료조새성수면호흡잠정저통기종합정（OSAHS）반비반적조발2형당뇨병적림상료효급안전성。방법장20례환자수궤분위대조조화관찰조，각10례。량조환자균여nCPAP치료，대조조환자재차기출상가복이갑쌍고，매차850 mg，3차/일；관찰조환자칙연합피하주사리랍로태，제1주0.6 mg/d，제2주1.2 mg/d，공치료12주。관찰환자체중지수（BMI）、공복혈당（FPG）、찬후2소시혈당（2 h PG）、당화혈홍단백（HbA1C）、공복이도소（FINS）、이도소저항지수（HOMA－IR）、혈지、호흡잠정－저통기지수（AHI）、최저혈양포화도（LSpO2）적변화。결과치료12주후，량조환자적 FPG，2 h PG，HbA1C，FINS， HOMA－IR、삼선감유（TG）급AHI균교치료전현저하강，LSpO2교치료전현저상승（ P<0.05）；여대조조상비，관찰조각항지표개선경명현（ P<0.05）。결론리랍로태연합nCPAP치료OSAHS반비반적조발2형당뇨병，료효급안전성균우우이갑쌍고。
Objective To investigate the clinical efficacy and safety of liraglutide combined with nasal continuous positive airway pres-sure(nCPAP)in treating early-onset type 2 diabetic mellitus(T2DM)of obstructive sleep apnea hypopnea syndrome(OSAHS)compli-cating obesity. Methods Totally 20 patients with early-onset T2DM of OSAHS complicating obesity were randomly divided into the control group and the observation group,10 cases in each group. The nCPAP therapy was performed in the two groups,on this basis ,the control group was took oral metformin 850 mg ,3 times daily ,while the observation group was subcutaneously injected by liraglutide 0. 6 mg/d in the first week and liraglutide 1. 2 mg/d from the second week. The levels of body mass index(BMI),fasting plasma glucose(FPG),postprandial 2 h blood glucose(2 h PG),glycosylated hemoglobin(HbA1C),fasting insulin(FINS),homeostasis mod-el assessment-insulin resistance(HOMA-IR)index,blood lipid and apnea-hyponea index(AHI)were observed after 12-week treat-ment. The changes of various indexes were compared between the two groups. Results The levels of FPG,2 h PG,HbA1C,FINS, HOMA-IR,TG and AHI after 12-week therapy in the two groups were significantly reduced compared with before treatment( P < 0. 05), while the lowest oxyhemoglobin satuation(LSpO2)level was increased( P < 0. 05);compared with the control group,the improvement of various indexes in the observation group was more significant( P < 0. 05). Conclusion The effect and safety of liraglutide combined with nCPAP for treating early-onset T2DM of OSAHS complicating obesity is superior to that of metformin.