摘要
目的:探究司美格鲁肽联合二甲双胍对2型糖尿病患者血糖控制达标率及心肌酶谱等的影响。方法:选取2022年1~9月某院收治的90例2型糖尿病患者作为研究对象,采用简单随机抽样法分为对照组和观察组,每组45例。所有患者均给予健康教育、饮食控制、运动等常规干预,对照组在常规干预基础上口服二甲双胍,观察组在对照组基础上加用司美格鲁肽注射液,两组均治疗8周。比较两组患者血糖水平[空腹血糖(FBG)、餐后2h血糖(2hPBG)、糖化血红蛋白(HbA1c)]、血糖控制达标率、胰岛素水平[空腹胰岛素(FINS)、饭后1h胰岛素(1hINS)]、胰岛素抵抗[胰岛素抵抗指数(HOMA-IR)]、心肌酶谱指标水平[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)]、血管内皮功能指标[一氧化氮(NO)、内皮素-1(ET-1)]及不良反应发生情况。结果:治疗后,两组患者FBG、2hPBG、HbA1c均降低,且观察组低于对照组(P<0.05);FBG和2hPBG达标率均升高,且观察组高于对照组(P<0.05);FINS、1hINS、HOMA-IR均降低,且观察组低于对照组(P<0.05);血清CK、CK-MB、LDH均降低,且观察组低于对照组(P<0.05);NO水平升高,且观察组高于对照组(P<0.05);ET-1水平降低(P<0.05),且观察组低于对照组(P<0.05)。两组患者不良反应总发生率比较无统计学差异(P>0.05)。结论:相较于单独使用二甲双胍,司美格鲁肽联合二甲双胍可有效提高2型糖尿病患者的血糖控制达标率,改善胰岛素抵抗及胰岛素水平,调节血管内皮功能,降低心肌酶谱指标水平,且安全性较高。
Objective:To explore the effect of semaglutide combined with metformin on standard-reaching rate of blood glucose and myocardial enzyme profile in patients with type 2 diabetes mellitus.Method:A total of 90 patients with type 2 diabetes mellitus treated at a certain hospital during the period between January and September in 2022 were selected and assigned to a control group and an observation group by the random number table,with 45 patients in each group.All patients were given conventional intervention such as health education,alimentary control and exercise,and those in the control group were additionally treated with oral metformin,whereas those in the observation group were given semaglutide injection in addition to the treatment given in the control group.Both groups were treated for 8 weeks.The blood glucose levels[fasting blood glucose(FBG),two hours postprandial blood glucose(2hPBG),glycosylated hemoglobin(HbA1c)],standard-reaching rate of blood glucose,insulin levels[fasting insulin(FINS),1-hour postprandial insulin(1hINS)],insulin resistance[homeostasis model assessment of insulin resistance(HOMA-IR)],myocardial enzyme indices[creatine kinase(CK),creatine kinase-MB(CK-MB),lactate dehydrogenase(LDH)],vascular endothelial function indicators[nitric oxide(NO),endothelin-1(ET-1)]and occurrence of adverse reactions were compared between the two groups.Results:After treatment,FBG,2hPBG and HbA1c levels decreased in both groups,and were lower in the observation group than those in the control group(P<0.05).Both FBG and 2hPBG compliance rate were increased,and were higer in the observation group than those in the control group(P<0.05).The FINS,1hINS and HOMA-IR levels decreased in both groups(P<0.05),and were lower in the observation group than those in the control group(P<0.05).The levels of serum CK,CK-MB and LDH decreased in both groups,and were lower in the observation group than those in the control group(P<0.05).The level of NO increased in both groups,and was higher in the observation group than that in the control group(P<0.05).The level of ET-1 decreased in both groups,and was lower in the observation group than that in the control group(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Compared with metformin alone,the combination of semaglutide and metformin effectively improved standard-reaching rate of blood glucose in patients with type 2 diabetes mellitus,improve insulin resistance and insulin level,regulate vascular endothelial function,and reduce levels of myocardial enzymes,with high safety profile.
作者
郭敬
施伟生
孙高洁
李俊霞
李翠柳
GUO Jing;SHI Wei-sheng;SUN Gao-jie;LI Jun-xia;LI Cui-liu(Department of Endocrinology,Puyang People's Hospital,Puyang 457000,China;Department of Endocrinology,Cangzhou Central Hospital,Cangzhou 061000,China)
出处
《中国合理用药探索》
CAS
2023年第12期49-55,共7页
Chinese Journal of Rational Drug Use
基金
沧州市重点研发计划指导项目(213106005)。
关键词
司美格鲁肽
二甲双胍
2型糖尿病
血糖控制达标率
心肌酶谱
semaglutide
metformin
type 2 diabetes mellitus
standard-reaching rate of blood glucose
myocardial enzyme profile
