司美格鲁肽联合胰岛素泵强化治疗对2型糖尿病患者内分泌代谢的影响

摘要/Abstract

摘要： 目的探讨与分析司美格鲁肽联合胰岛素泵强化治疗对2型糖尿病（Type 2 diabetes mellitus,T2DM）患者内分泌代谢的影响。方法选择2021年9月~2022年3月在哈尔滨市第四医院就诊的2型糖尿病患者60例作为研究对象,根据随机数表法把患者分为司美格鲁肽组与对照组,各30例。对照组给予胰岛素泵强化治疗,司美格鲁肽组在对照组治疗的基础上给予司美格鲁肽治疗,两组都治疗观察3个月,测定与记录患者内分泌代谢变化情况。结果治疗后,两组的空腹血糖、餐后2 h血糖都显著低于治疗前,司美格鲁肽组也显著低于对照组,差异有统计学意义（P<0.05）。治疗后,两组总胆固醇、低密度脂蛋白胆固醇、甘油三酯水平都显著低于治疗前,高密度脂蛋白胆固醇都高于治疗前,差异有统计学意义（P<0.05）,司美格鲁肽组总胆固醇、低密度脂蛋白胆固醇、甘油三酯水平低于对照组,高密度脂蛋白胆固醇高于对照组,差异有统计学意义（P<0.05）。治疗后,两组糖化血红蛋白都明显低于治疗前,C肽明显高于治疗前,差异有统计学意义（P<0.05）,司美格鲁肽组糖化血红蛋白明显低于对照组,C肽明显高于对照组,差异有统计学意义（P<0.05）。治疗后,司美格鲁肽组活力、精神健康、生理职能、社会功能、情感职能、生理机能、总体健康、躯体疼痛等生存质量评分都显著高于对照组,差异有统计学意义（P<0.05）。结论司美格鲁肽联合胰岛素泵强化治疗在2型糖尿病患者中应用能促进降低空腹血糖、餐后2 h血糖、糖化血红蛋白水平,提高患者的C肽水平,还可改善患者的血脂水平,提高患者的生存质量。

关键词: 司美格鲁肽, 胰岛素泵强化治疗, 2型糖尿病, 内分泌代谢

Abstract: Objective To investigate and analysis the effect of semaglutide combined with intensive insulin pump therapy on endocrine metabolism in patients with type 2 diabetes mellitus (T2DM). Methods A total of 60 patients with type 2 diabetes mellitus who were treated in the Endocrinology Department of the Fourth Hospital of Harbin were selected as the research subjects from September 2021 to March 2022, according to the random number table method, the patients were divided into the semaglutide group and the control group, with 30 cases in each group. The control group was given intensive insulin pump therapy, and the semaglutide group was given semaglutide treatment on the basis of the treatment of the control group. Both groups were treated for 3 months, and the endocrine and metabolic changes of the patients were measured and recorded. Results After treatment, the fasting blood glucose and 2 h postprandial blood glucose of the semaglutide group and the control group were significantly lower than those before treatment (P<0.05), and the semaglutide group was also significantly lower than the control group (P<0.05). After treatment, the levels of total cholesterol, low-density lipoprotein cholesterol and triglyceride in the two groups were significantly lower than those before treatment (P<0.05), and high-density lipoprotein cholesterol was higher than that before treatment (P<0.05), the levels of total cholesterol, low-density lipoprotein cholesterol and triglyceride in the semaglutide group were significantly lower than those in the control group (P<0.05), and high-density lipoprotein cholesterol was higher than the control group (P<0.05). After treatment, the glycosylated hemoglobin in the two groups was significantly lower than that before treatment (P<0.05), and the C-peptide was significantly higher than that before treatment (P<0.05), the glycosylated hemoglobin in the semaglutide group was significantly lower than that in the control group (P<0.05), and the C-peptide was significantly higher than that in the control group (P<0.05). The quality of life scores of vitality, mental health, physiological function, social function, emotional function, physiological function, general health, and physical pain in the semaglutide group after treatment were significantly higher than those in the control group (P<0.05). Conclusion The application of semaglutide combined with intensive insulin pump therapy in patients with type 2 diabetes mellitus can promote the reduction of fasting blood glucose, 2 h postprandial blood glucose, and glycosylated hemoglobin levels, increase the level of C-peptide in patients, and also improve the level of blood lipids in patients and quality of life of patients.

Key words: semaglutide, intensive insulin pump therapy, type 2 diabetes mellitus, endocrine metabolism

中图分类号:

R587.1

李媛红, 马琳娜. 司美格鲁肽联合胰岛素泵强化治疗对2型糖尿病患者内分泌代谢的影响[J]. 中华养生保健, 2022, 40(23): 11-14.

LI Yuan-hong, MA Lin-na. Effects of Semaglutide Combined with Intensive Insulin Pump Therapy on Endocrine Metabolism in Patients with Type 2 Diabetes Mellitus[J]. ZHONGHUA YANGSHENG BAOJIAN, 2022, 40(23): 11-14.

参考文献

[1] 李萌,林矗,罗樱樱,等.胰岛素强化治疗后转换为德谷门冬双胰岛素治疗新诊断糖尿病一例[J].中华糖尿病杂志,2021,13(Z1):1-4.
[2] 黄建丽,马艳.阿格列汀联合胰岛素泵持续皮下输注治疗门冬胰岛素30控制不佳的2型糖尿病患者的效果[J].河南医学研究,2021, 30(28):5319-5322.
[3] 陈凯庭,安艳荣,董学勤,等.新诊断2型糖尿病患者采用短期胰岛素泵强化治疗的效果[J].中国老年学杂志,2021,41(5):945-948.
[4] 郭艳琼,彭晶,李庆德,等.基于OpenFDA数据挖掘和分析司美格鲁肽的不良事件报告信号[J].中国药师,2022,25(3):475-478.
[5] 新型降糖药司美格鲁肽周制剂在华获批,兼顾强效降糖与心血管代谢获益![J].中国循证心血管医学杂志,2021,13(5):636.
[6] 刘晴晴,孙殿静,侯丽萍,等.住院2型糖尿病患者皮下胰岛素泵降糖后血糖波动的影响因素分析[J].重庆医学,2022,51(4):601-606.
[7] 张童童,芮凤,张雪英.胰岛素泵对妊娠期糖尿病患者血糖同型半胱氨酸C-反应蛋白水平及分娩结局的影响[J].中国妇幼保健,2022, 37(1):26-29.
[8] 林莉,郑燕蓉,崔玮.糖尿病专科护士主导的胰岛素泵管理在老年糖尿病患者中的应用[J].中华现代护理杂志,2022,28(11):1504-1508.
[9] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(基层版)[J].中华全科医师杂志,2013,12(8):1227-1245.
[10] 王蓉蓉,宫雯雯.1例PD-1抑制剂相关暴发性1型糖尿病病例报道及文献复习[J].中国药物应用与监测,2022,19(1):58-60.
[11] 杨春杰,崔琦,张帅,等.以胰岛素泵强化为核心序贯治疗初诊2型糖尿病[J].中国老年学杂志,2021,41(5):941-945.
[12] Davies M, Færch L, Jeppesen O K, et al.Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial[J]. Lancet,2021,397(10278):971-984.
[13] 曾苹,惠娇,王双.PLR NLR对胰岛素泵治疗2型糖尿病远期疗效及MACE的预测价值[J].临床心身疾病杂志,2021,27(6):97-100.
[14] 井庆平,孙爱东,李媛,等.血糖日平均危险范围指数对胰岛素泵强化治疗2型糖尿病患者胰岛功能改善的影响[J].山东医药,2021,61(22):63-65.
[15] Wadden T A, Bailey T S, Billings L K, et al.Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults With Overweight or Obesity: The STEP 3 Randomized Clinical Trial[J]. JAMA,2021,325(14):1403-1413.
[16] 赵正历,冯玉俊,耿建林,等.利拉鲁肽与格列美脲对胰岛素泵治疗欠佳2型糖尿病患者的安全性和血管获益的对比研究[J].中国医院用药评价与分析,2021,21(4):428-431.
[17] 姚刚,丁艳,卫晓婷,等.醒脑静注射液、胰岛素泵联合减压术治疗重型颅脑损伤合并糖尿病的临床疗效[J].中华内分泌外科杂志,2021,15(4):423-427.
[18] 李胜男,王祺,郑振,等.连续胰岛素泵输注对新诊断2型糖尿病患者左心室功能的影响[J].心肺血管病杂志,2021,40(11):1122-1125.
[19] 曾艳,刘晓楠,沈江华,等.择期全身麻醉手术禁食2型糖尿病患者围术期血糖管理分析与评价[J].中国药业,2021,30(19):120-124.
[20] 马晓云. 胰岛素泵联合利格列汀对2型糖尿病患者血糖及胰岛素抵抗的影响[J].黑龙江医药,2021,34(1):106-108.