标题：利拉鲁肽治疗多种药物联用疗效不佳的肥胖2型糖尿病患者疗效观察

      作者：王 艳，管一平，蔡 雪
    (宜宾市第二人民医院南区内科，四川 宜宾 644000)

      卷次： 2014年25卷11期

      【摘要】 目的 观察利拉鲁肽对多种口服降糖药物联用并和胰岛素联合治疗疗效不佳的肥胖2型糖尿病患
者的临床疗效和安全性。方法 选择对多种口服降糖药物联用并和胰岛素联合治疗疗效不佳的肥胖 2型糖
尿病患者 21例，在原有治疗基础上加用利拉鲁肽治疗 12周。观察比较治疗前后的空腹血糖(FBG)、餐后 2 h
血糖(2 hPBG)、糖化血红蛋白(HbA1c)、体重指数(BMI)、血脂、血压、空腹胰岛素（FIns）、稳态模型胰岛素抵抗指
数(HOMA-IR)、稳态模型胰岛β细胞分泌指数(HOMA-β)、胰岛素使用量及不良反应等指标。结果 加用利拉鲁
肽治疗12周后，患者的FBG、2 hPBG、HbA1c、TG、BMI、FIns、HOMA-IR、胰岛素用量均明显下降，差异有统计学意
义(P<0.05)。治疗后的HOMA-β与治疗前比较明显升高，差异有统计学意义(P<0.05)。主要的不良反应为胃肠道
反应及低血糖，但两者均较轻微且短暂。结论 对多种口服降糖药物联用且和胰岛素联合治疗后血糖仍控制欠佳
的肥胖2型糖尿病患者，利拉鲁肽可有效控制血糖，改善胰岛素抵抗，提高胰岛素敏感性，增强胰岛β细胞功能。

      【关键词】 糖尿病；肥胖；利拉鲁肽

      【中图分类号】 R587.1 【文献标识码】 A 【文章编号】 1003—6350（2014）11—1578—04


Efficacy of liraglutide on obese type 2 diabetes patients with poor response to combinations with a variety of
drugs.
WANG Yan, GUAN Yi-ping, CAI Xue. Southern Department of Internal Medicine, the Second People's Hospital of
Yibin, Yibin 644000, Sichuan, CHINA

【Abstract】 Objective To observe the clinical efficacy and safety of liraglutide on obese type 2 diabetes pa-
tients with resistant to combinations of oral hypoglycemic drugs and insulin. Methods Twenty one obese type 2 dia-
betic patients with resistant to combinations of oral hypoglycemic drugs and insulin were investigated. Liraglutide
were added to the original treatment strategy for 12 weeks and its effects were observed on fasting blood glucose
(FBG), 2h postprandial blood glucose (2hPBG), glycosylated hemoglobin (HbA1c), body mass index (BMI), blood lip-
ids, blood pressure, fasting insulin (FIns), homeostasis model assessment of insulin resistance index (HOMA- IR), ho-
meostasis model assessment index of pancreatic β cell secretion (HOMA-β), insulin dosage and adverse reactions.
Results The patient's FBG, 2hPBG, HbA1c, TG, BMI, FIns, HOMA-IR, and insulin dosage decreased significant-
ly after 12 weeks of treatment with Liraglutide (P<0.05). HOMA-β increased remarkably after Liraglutide treat-
ment (P<0.05). The main adverse reactions were gastrointestinal reactions and low blood sugar, both of which
were mild and transient. Conclusion For obese type 2 diabetic patients with poorly controlled blood glucose even
underwent combination therapy of multiple oral hypoglycemic drugs and insulin, liraglutide can effectively control
blood sugar, improve insulin resistance and insulin sensitivity, and enhance islet β cells function.

      【Key words】 Diabetes mellitus; Obesity; Liraglutide