利拉鲁肽联合胰岛素和格列吡嗪治疗亚甲减合并2型糖尿病老年患者的临床研究

发布时间：2018-06-03 22:11

本文选题：利拉鲁肽 + 亚临床性甲状腺功能减退症　；参考：《中国药房》2017年14期

【摘要】：目的:观察利拉鲁肽联合胰岛素和格列吡嗪治疗亚临床性甲状腺功能减退症(以下简称"亚甲减")合并2型糖尿病的老年患者的效果及安全性。方法:选取2013年12月-2015年12月我院收治的亚甲减合并2型糖尿病老年患者82例,按照随机数字表法分为试验组(40例)和对照组(42例)。对照组患者给予胰岛素注射液+格列吡嗪片;试验组患者在此基础上给予利拉鲁肽注射液0.6 mg,sc,qd。两组患者均连续治疗12周。观察两组患者治疗前后的血糖[空腹血糖、餐后1 h和2 h血糖、日间血糖平均绝对差(MODD)、平均血糖波动幅度(MAGE)]、糖化血红蛋白、体质量、总胆固醇、血压(收缩压、舒张压)、促甲状腺激素(TSH)和胰岛B细胞功能指数(HOMA-B)水平,并记录不良反应发生情况。结果:对照组患者脱落4例,试验组无脱落病例。治疗前,两组患者血糖、糖化血红蛋白、体质量、总胆固醇、血压、TSH和HOMA-B等水平比较,差异均无统计学意义(P0.05)。治疗后,试验组患者的体质量和总胆固醇水平均明显降低,且明显低于对照组,差异均有统计学意义(P0.05);两组患者血糖、糖化血红蛋白、血压和TSH水平均明显降低,HOMA-B水平明显升高,且试验组明显优于对照组,差异均有统计学意义(P0.05)。试验组患者总不良反应发生率(12.5%)与对照组(19.0%)比较,差异无统计学意义(P0.05)。结论:利拉鲁肽联合胰岛素和格列吡嗪治疗亚甲减合并2型糖尿病的老年患者,可有效降糖并稳定机体血糖水平,控制体质量增加,改善胰岛B细胞功能,且安全性较好。
[Abstract]:Aim: to observe the efficacy and safety of liraropeptide combined with insulin and glipizide in the treatment of subclinical hypothyroidism (hypothyroidism) in elderly patients with type 2 diabetes mellitus. Methods: from December 2013 to December 2015, 82 elderly patients with subhypothyroidism combined with type 2 diabetes mellitus were randomly divided into two groups: the experimental group (n = 40) and the control group (n = 42). The patients in the control group were given insulin injection glipizide tablet, and the patients in the test group were given the injection 0.6 mg / g scroqd. on this basis. The patients in both groups were treated continuously for 12 weeks. Before and after treatment, blood glucose [fasting blood glucose, 1 h and 2 h postprandial blood glucose, average absolute difference in daytime blood glucose, mean fluctuation of blood glucose (MAGE)], glycosylated hemoglobin, body mass, total cholesterol, blood pressure (systolic blood pressure) were observed in both groups. The levels of diastolic blood pressure (DBP), thyroid stimulating hormone (TSH) and islet B cell function index (Homa-B) were recorded and the adverse reactions were recorded. Results: there were 4 cases in the control group and 4 cases in the test group. Before treatment, the levels of blood glucose, glycosylated hemoglobin, body mass, total cholesterol, blood pressure, TSH and HOMA-B were not significantly different between the two groups (P 0.05). After treatment, the body weight and total cholesterol level of the patients in the trial group were significantly lower than those in the control group, and the differences were statistically significant (P 0.05). The blood pressure and TSH level were significantly decreased and the level of HOMA-B was significantly increased in the experimental group than in the control group, and the difference was statistically significant (P 0.05). There was no significant difference in the incidence of total adverse reactions between the trial group and the control group (P 0.05). Conclusion: the combination of liraropeptide and insulin and glipizide in the treatment of elderly patients with subhypothyroidism combined with type 2 diabetes can effectively reduce blood sugar, stabilize body blood sugar level, control body mass increase, improve the function of islet B cells and improve the function of islet B cells.
【作者单位】：保定市第一中心医院老年病二科;保定市第一中心医院体检科;保定市第一医院普外科;河北大学附属医院神经内科;
【分类号】：R581.2;R587.1

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