【摘要】 目的:比较胰高血糖素样肽-1(Glucagon like peptide-1,GLP1)受体激动剂(利拉鲁肽和钠-葡萄糖协同转运蛋白2(Sodium-dependent glucose transporters 2,SGLT2)抑制剂(达格列净)分别联合二甲双胍治疗2型糖尿病的疗效。方法:2021年1月到2021年12月本医院接诊的120例糖尿病患者，随机分为三组，每组40例，设为对照组(二甲双胍)、治疗A组(二甲双胍+利拉鲁肽)、治疗B组(二甲双胍+达格列净)。全自动生化分析仪和酶联免疫吸附试验(Enzyme linked immunosorbent assay,ELISA)检测治疗前后患者血糖指标空腹血糖(Fasting blood glucose,FPG)、餐后2 h血糖(Blood glucose2 hours after meal,2hPBG)、糖化血红蛋白(Glycosylated hemoglobin,HbA1c)、胰岛素抵抗指数(Insulin resistance index,HOMA-IR)的水平，血脂指标甘油三酯(Triglyceride,TG)、总胆固醇(Total cholesterol,TC)、高密度脂蛋白胆固醇(High density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterol,LDL-C)的水平。结果:与治疗前相比，三组患者治疗后FPG、2hPBG、HbA1c、HOMA-IR水平均显著降低(P <0.05)，血脂指标TG、TC、LDL-C水平均显著降低(P <0.05),A组、B组HDL-C水平显著升高(P <0.05)。与对照组相比，治疗后A组、B组FPG、2hPBG、HbA1c、HOMA-IR、TG水平均显著降低(P<0.05),LDL-C和HDL-C的差异不显著(P>0.05)。与治疗A组相比，B组FPG、2hPBG的水平显著降低，HbA1c、HOMA-IR、TG、TC、LDL-C的水平虽有降低，但是差异不显著(P> 0.05)。三组患者的不良反应率分别为27.5%、27.5%、25%。结论:SGLT2抑制剂联合二甲双胍治疗2型糖尿病的降糖、降脂效果优于GLP1受体激动剂联合二甲双胍。更多还原

【Abstract】 Objective: To compare the effecacy of glucagon-like peptide-1( GLP1) receptor agonist( liraglutide) and sodium-glucose co-transporters 2( SGLT2) Efficacy of inhibitors( dapagliflozin) combined with metformin in the treatment of type 2 diabetes,respectively. Methods: From January 2021 to December2021,120 diabetic patients admitted to our hospital were randomly divided into 3 groups,with 40 cases in each group,as control group( metformin),treatment group A( metformin + liraglutide)),treatment group B( metformin + dapagliflozin). Automatic biochemical analyzer and enzyme-linked immunosorbent assay( ELISA)were used to detect the blood glucose indexes of patients before and after treatment: fasting blood glucose( FPG),blood glucose 2 hours after meal( 2hPBG),glycated hemoglobin( glycosylated hemoglobin,HbA1c),insulin resistance index( insulin resistance index,HOMA-IR) levels,blood lipid indicators triglyceride( triglyceride,TG),total cholesterol( total cholesterol,TC),high-density lipoprotein cholesterol( high density lipoprotein cholesterol,HDL-C),low density lipoprotein cholesterol( low density lipoprotein cholesterol,LDL-C) levels.Results: Compared with before treatment,the levels of FPG,2hPBG,HBA1c and HOMA-IR significantly decreased after treatment( P <0.05),and the TG,TC and LDL-C significantly decreased( P < 0.05),HDL-C significantly increased in the three groups of patients after treatment( P < 0. 05). Compared with the control group,the levels of serum FPG,2hPBG,HBA1c,HOMA-IR and TG significantly decreased in group A and group B after treatment( P <0.05),and TC,LDL-C and HDL-C had no significant difference in group A and group B after treatment( P >0.05).Compared with group A,the levels of FPG and 2hPBG significantly decreased( P >0.05),while the levels of HBA1c,HOMA-IR,TG,TC and LDL-C decreased,with no significant difference in group B( P >0.05).The adverse reaction rates of the three groups were 27.5%,27.5% and 25%,respectively.Conclusion: The SGLT2 inhibitor combined with metformin in reducing blood sugar and lipid-lowering in type 2 diabetes was superior to GLP1 receptor agonist combined with metformin.更多还原