南方医科大学学报

南方医科大学学报 ›› 2023, Vol. 43 ›› Issue (3): 436-442.doi: 10.12122/j.issn.1673-4254.2023.03.14

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二甲双胍/维格列汀和利拉鲁肽对肥胖合并2型糖尿病患者的临床疗效比较

周 蓓，李 静，方晨圆，黄亚楠，桑贵蕊，陶少平，何春玲   

  1. 皖南医学院第二附属医院内分泌科，安徽 芜湖 241001；皖南医学院第一附属医院内分泌科，安徽 芜湖 241004
  • 出版日期:2023-03-20 发布日期:2023-03-20

Comparison of therapeutic effect of metformin hydrochloride/vildagliptin and liraglutide on type 2 diabetes mellitus in obese patients

ZHOU Bei, LI Jing, FANG Chenyuan, HUANG Yanan, SANG Guirui, TAO Shaoping, HE Chunling   

  1. Department of Endocrinology, Second Affiliated Hospital of Wannan Medical College, Wuhu 241001, China; Department of Endocrinology, First Affiliated Hospital of Wannan Medical College, Wuhu 241004, China
  • Online:2023-03-20 Published:2023-03-20

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摘要： 目的 评价基于二甲双胍/维格列汀和利拉鲁肽的两种治疗方案对肥胖合并2型糖尿病患者（BMI>25 kg/m2）的临床疗效。方法 回顾性分析2019~2022年皖南地区107例肥胖合并2型糖尿病患者，根据所选患者初发肥胖合并2型糖尿病，将患者分为二甲双胍/维格列汀治疗组（n=53）和利拉鲁肽治疗组（n=54），持续治疗3个月。比较两组患者治疗前后的BMI、腹围、空腹血糖、餐后2 h血糖、糖化血红蛋白、空腹C肽、餐后2 hC肽、空腹胰岛素及餐后2 h胰岛素，观察治疗前后各项指标的变化。结果 107例皖南地区肥胖合并2型糖尿病患者中，二甲双胍/维格列汀组和利拉鲁肽组患者治疗前后的BMI（P<0.05）、腹围（P<0.05）、空腹血糖（P<0.05）、餐后2 h血糖（P<0.05）以及糖化血红蛋白（P<0.05）均较前下降，空腹C肽及餐后2 hC肽较前恢复（P<0.05）。对比两组治疗结果，血糖下降水平疗效相当，但利拉鲁肽组的腹围减少疗效更优（P<0.01），两组治疗方案对患者的胰岛素水平影响并不显著（P>0.05）。结论 二甲双胍/维格列汀和利拉鲁肽作为新型降糖药物，对于肥胖合并2型糖尿病具有很好疗效，可以控制血糖、减轻体质量，但利拉鲁肽对患者体质量的控制效果相对更佳。

关键词: 肥胖合并2型糖尿病；二甲双胍/维格利汀；利拉鲁肽

Abstract: Objective To evaluate the therapeutic effects of two therapeutic strategies based on metformin hydrochloride/vildagliptin and liraglutide on type 2 diabetes mellitus (T2DM) in obese patients. Methods We retrospectively collected the clinical data of 107 obese patients (BMI>25 kg/m2) with T2DM treated in Second Affiliated Hospital of Wannan Medical College (Wuhu, China) during 2019-2021, including 53 patients treated continuously with metformin hydrochloride/vildagliptin and 54 with liraglutide for 3 months. The changes in BMI, waist circumference, fasting blood glucose (FBG), postprandial blood glucose, HbA1C, fasting C-peptide, postprandial C-peptide, fasting insulin and postprandial insulin of the patients after treatment were compared between the two groups. Results In both of the groups, the patients all showed significant reductions of BMI, waist circumference, FBG, postprandial blood glucose and HbA1C (all P<0.05) with improved fasting and postprandial C-peptide levels after the treatments (P<0.05). The two treatment regimens showed comparable blood glucose-lowering effects, but liraglutide produced better effect in reducing waist circumference (P<0.01). Neither of two regimens obviously affected insulin level of the patients (P>0.05). Conclusion Both metformin hydrochloride/vildagliptin and liraglutide have good therapeutic effects on T2DM in obese patients and can achieve good blood glucose and weight control, but liraglutide has a better effect for weight control.

Key words: type 2 diabetes mellitus; obesity; metformin hydrochloride/vildagliptin; liraglutide