CAJ | 학술논문

目的：评价利拉鲁肽联合门冬胰岛素30治疗难治性2型糖尿病的临床疗效及安全性。方法将78例2型糖尿病患者随机分为对照组38例和试验组40例。2组患者均予以门冬胰岛素30联合口服降糖药。对照组予以地特胰岛素皮下注射，睡前1次，起始剂量0．2 U? kg－1? d－1；试验组予以利拉鲁肽皮下注射，睡前1次，起始剂量0．6 mg? d－1，1周后剂量为1．2 mg? d－1。2组患者均治疗16周。比较2组患者血糖控制的总有效率、胰岛素抵抗指数及胰岛素使用剂量、体重改变与低血糖发生率。结果治疗后，2组患者的空腹血糖、餐后2h血糖、糖化血红蛋白及日间胰岛素使用量均较治疗前显著下降（均P＜0．01）。治疗后，2组患者在控制血糖的总有效率上差异无统计学意义（ P＞0．05），但试验组的空腹 C 肽、餐后2 h 血糖及胰岛素抵抗指数均明显低于对照组（P＜0．05），体重显著下降（P＜0．01），日间胰岛素使用量明显减少（P＜0．05），低血糖发生率显著下降（ P＜0．05）。结论利拉鲁肽联合门冬胰岛素30治疗难治性2型糖尿病的临床疗效确切，不良反应少，较地特胰岛素有更多的获益。
목적：평개리랍로태연합문동이도소30치료난치성2형당뇨병적림상료효급안전성。방법장78례2형당뇨병환자수궤분위대조조38례화시험조40례。2조환자균여이문동이도소30연합구복강당약。대조조여이지특이도소피하주사，수전1차，기시제량0．2 U? kg－1? d－1；시험조여이리랍로태피하주사，수전1차，기시제량0．6 mg? d－1，1주후제량위1．2 mg? d－1。2조환자균치료16주。비교2조환자혈당공제적총유효솔、이도소저항지수급이도소사용제량、체중개변여저혈당발생솔。결과치료후，2조환자적공복혈당、찬후2h혈당、당화혈홍단백급일간이도소사용량균교치료전현저하강（균P＜0．01）。치료후，2조환자재공제혈당적총유효솔상차이무통계학의의（ P＞0．05），단시험조적공복 C 태、찬후2 h 혈당급이도소저항지수균명현저우대조조（P＜0．05），체중현저하강（P＜0．01），일간이도소사용량명현감소（P＜0．05），저혈당발생솔현저하강（ P＜0．05）。결론리랍로태연합문동이도소30치료난치성2형당뇨병적림상료효학절，불량반응소，교지특이도소유경다적획익。
Objective To evaluate the efficacy and safety of liraglutide ( Lira) combined with insulin aspart 30 injection in the treatment of type 2 diabetes poorly controlled with premixed insulin aspart 30 ( Asp 30 ) . Methods Seventy eight patients with type 2 diabetes mellitus without reaching glycemic targets were randomized into two groups.On the basis of the insulin aspart 30 and oral hypoglycemic drugs, the patients in the trial group were given liraglutide 0.6 mg? d-1 sc once per night for the first week, and 1.2 mg? d-1 for the following two to sixteen weeks, while the other patients in the control group received insulin detemir ( Det) sc once a night for 16 weeks, with the beginning dosage of 0.2 U? kg -1? d-1.Before and after the treatment, the body mass index ( BMI) , waist to hip ratio ( WHR) , fasting plasma glucose ( FPG) , fast-ing C -peptide ( FCP ) , 2 -hour postprandial plasma glucose (PPG 2 h), glycosylated hemoglobin A1c (HbA1c) and insulin resist-ance index(HOMA-IR) were tested.Also, the adverse drug reactions such as weight gain and hypoglycemia reaction were estimated. Results After the treatment, the level of FPG, PPG 2 h and HbA1c decreased obviously in both groups ( P<0.01 ) , while PPG 2 h in the trial group appeared a better improvement compared to the control group ( P<0.05) ,and BMI as well as HOMA-IR was improved significantly in the trial group after the treatment ( P<0.01).Both drugs were well tolerated with minor hypoglycemia, yet Lira appeared much safer than Det.Conclusion For treatment of refractory type 2 diabetes mellitus, liraglutide combined with insulin aspart 30 injection had certain clincal efficacy with minor adverse reaction.