长效GLP-1类似物与甘精胰岛素治疗2型糖尿病疗效性及安全性的meta分析

发布时间：2018-01-31 00:59

本文关键词： 长效GLP-1类似物甘精胰岛素 2型糖尿病 Meta分析　出处：《重庆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:评价长效GLP-1类似物与甘精胰岛素治疗血糖控制不佳的2型糖尿病人的疗效性及安全性。方法:本文采用“胰高血糖素样肽-1、艾塞那肽周制剂、阿必鲁肽、杜拉糖肽与甘精胰岛素”等检索词,检索CNKI、CBM、VIP、万方、Pubmed、Embase及Cochrane数据库,检索时间为建库至2016年12月。按照入排标准,筛选出在常规降糖药物治疗效果不佳的基础上采用长效GLP-1类似物与甘精胰岛素治疗方案的疗效性及安全性比较的研究,并提取相应数据。评价结局指标包括Hb A1c、FPG、2h PG、体重变化、低血糖、胃肠道反应及局部注射反应等。按Cochrane系统评价的方法对所纳入文献质量进行评估。应用Revman 5.3软件以WMD或RR为效应量进行综合定量分析,采用I2值检验各研究间的异质性,以0.05作为检验水准。结果:最终纳入6篇RCT,共计3112例患者。综合数据分析结果显示长效GLP-1类似物组与甘精胰岛素组相比,Hb A1c、FPG、体重变化值分别为-0.23%(95%CI:-0.43~-0.02,P0.05)、0.73mmol/L(95%CI:0.13~1.32,P0.05)、-2.49kg(95%CI:-3.25~-1.73,P0.05);该组药物胃肠道反应(RR:3.18,95%CI:2.42~4.17,P0.05)及局部注射反应(RR:7.25,95%CI:3.01~17.48,P0.05)较常见,而低血糖(RR:0.62,95%CI:0.43~0.89,P0.05)及严重低血糖事件(RR:0.47,95%CI:0.22~0.99,P=0.05)发生率低。同样,胰腺炎、甲状腺肿瘤及严重心血管事件发生率极低。结论:长效GLP-1类似物可有效控制血糖、改善体重、降低低血糖发生率。但二者在2型糖尿病患者应用的长期疗效性及安全性比较有待于研究周期更长的临床试验来验证。
[Abstract]:Objective: to evaluate the efficacy and safety of long-acting GLP-1 analogues and insulin glargine in the treatment of type 2 diabetes patients with poor blood glucose control. Methods: "glucagon like peptide 1" was used in this study. The keywords of week preparation of Isenapeptide, Abiropeptide, Dula-glycopeptide and insulin glargine were searched. Embase and Cochrane database, the retrieval time is until December 2016. According to the entry standard. On the basis of the low efficacy of conventional hypoglycemic drugs, the efficacy and safety of long-term GLP-1 analogues and insulin glargine were compared. The outcome indexes included HbA1cFPGG 2h PG2, body weight change and hypoglycemia. Gastrointestinal reaction and local injection reaction. The quality of literature was evaluated by Cochrane system. Revman was used to evaluate the quality of the literature. 5.3 the effect quantity of WMD or RR was analyzed. I 2 value was used to test the heterogeneity of each study, and 0. 05 was taken as the test level. Results: 6 RCT articles were included. A total of 3112 patients were involved. Comprehensive data analysis showed that the long-acting GLP-1 analogue group was compared with insulin glargine group. The weight change values were -0.23 and 95, respectively, and CI: -0.43% -0.02% P0.05 / 0.73 mmol / L ~ (95) CI: 0.13 / 1.32. P0.05 ~ 2.49 kg ~ (95) CI: -3.25 ~ (-1.73) P0.05; The Gastrointestinal reaction of this group was as follows: RR: 3.1895 CI: 2.42 4.17 P0.05) and local injection reaction RR: 7.25. 95 CI: 3.01 / 17.48 (P0.05), while hypoglycemia is more common than R: 0.6295 CI: 0.430.89. P 0.05) and severe hypoglycemia events RR: 0.47 / 95 CI: 0.220.0.99p 0.05. similarly, pancreatitis was found in the patients with severe hypoglycemia (P < 0.05) and severe hypoglycemia events (RR: 0.47 / 95). The incidence of thyroid neoplasms and severe cardiovascular events is very low. Conclusion: Long-term GLP-1 analogues can effectively control blood glucose and improve body weight. To reduce the incidence of hypoglycemia, however, the long-term efficacy and safety of the two methods in type 2 diabetes need to be verified in clinical trials with a longer study period.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1

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