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目的探讨利拉鲁肽对2型糖尿病患者糖化血红蛋白(Hb A1c)、体重指数(BMI)及肝脏影响的相关性。方法选取2011年11月至2014年6月医院收治的61例2型糖尿病患者作为研究对象,所有患者均在口服降血糖、血脂、血压药物基础上,联合采用利拉鲁肽进行治疗。收集患者相关资料信息,观察其治疗前后Hb A1c、BMI、总胆固醇(CHOL)、三酯甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、谷氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(STB)、碱性磷脂酶(ALKP)、γ-谷氨酰转肽酶(GGT)、胆碱酯酶(Ch E)变化情况。结果用药后患者各指标均有不同程度改善。Hb A1c[-0.50(-0.95,0.45),P=0.042]、BMI[-1.02(-2.60,-0.16),P=0.000],均有所降低;TRIG降低[-0.54(-1.31,0.31),P=0.002]、HDL-C升高[0.07(-0.08,0.25),P=0.012];肝功能各指标降低,其中ALT[-7.0(-17.50,0.00),P=0.000],AST[-3.0(-11.00,1.00),P=0.000],ALKP[-5.0(-15.50,4.00),P=0.019],GGT[-9.0(-30.50,-3.00),P=0.000],Ch E[-0.39(-1.31,0.56),P=0.007]的降低具有统计学意义;使用利拉鲁肽后Hb A1c的降低和BMI的减少无关联(r=-0.038,P=0.769)。SBP和TRIG(r=-0.278,P=0.030),T-Chol和TRIG(r=0.285,P=0.026)、HDL(r=0.388,P=0.002)、LDL(r=0.691,P=0.000)有关。在BMI的改善跟ALT和AST存在负相关性(前者r=-0.254,P=0.048;后者r=-0.262,P=0.042),Hb A1c的减少跟STB的用药前数值有负相关(r=-0.410,P=0.001)。结论利拉鲁肽可以改善2型糖尿病患者Hb A1c、BMI、血脂和肝功能;且其对Hb A1c和BMI的改善是以独立的两个效果存在的。
Objective To investigate the relationship between liraglutide and HbA1c, body mass index (BMI) and liver in type 2 diabetic patients. Methods Sixty-one patients with type 2 diabetes treated in our hospital from November 2011 to June 2014 were enrolled in this study. All patients were treated with liraglutide on the basis of oral hypoglycemic agents, lipids and blood pressure. The data of patients were collected to observe the changes of Hb A1c, BMI, CHOL, TG, LDL-C, HDL-C, Aspartate aminotransferase (AST), total bilirubin (STB), alkaline phosphatase (ALKP), γ-glutamyl transpeptidase (GGT), cholinesterase Ch E) changes. Results After treatment, the indicators of patients improved to varying degrees. Hb A1c [-0.50 (-0.95,0.45), P = 0.042], BMI [-1.02 (-2.60, -0.16), P = 0.000] , P = 0.002], HDL-C increased [0.07 (-0.08,0.25), P = 0.012]; liver function decreased, ALT [-7.0 (-17.50,0.00), P = -3.0 (-11.00, 1.00), P = 0.000], ALKP [-5.0 (-15.50,4.00), P = 0.019], GGT [-9.0 (-30.50, -3.00) -0.39 (-1.31,0.56), P = 0.007]. There was no correlation between reduction of Hb A1c and reduction of BMI after using liraglutide (r = -0.038, P = 0.769). SBP and TRIG (r = -0.278, P = 0.030), T-Chol and TRIG (r = 0.285, P = 0.026) related. There was a negative correlation between improvement of BMI and ALT and AST (r = -0.254, P = 0.048; r = -0.262, P = 0.042) = -0.410, P = 0.001). Conclusion Liraglutide can improve Hb A1c, BMI, lipid and liver function in patients with type 2 diabetes mellitus, and its improvement on Hb A1c and BMI exists in two independent effects.