目的：探讨利拉鲁肽联合盐酸二甲双胍治疗维吾尔族和汉族肥胖2型糖尿病（T2DM）的临床疗效。方法采用开放式随机对照研究的方法，按照序贯进入的原则，选择新疆医科大学第一附属医院住院的肥胖T2DM 患者132例，其中利拉鲁肽＋盐酸二甲双胍组66例（维吾尔族21例，汉族45例），盐酸二甲双胍组66例（维吾尔族29例，汉族37例）。比较两组患者治疗前及治疗后3、6个月体质指数（BMI）、糖化血红蛋白（HBA1c）、腰臀比（WHR）、空腹血糖、餐后2 h 血糖、收缩压／舒张压及低密度脂蛋白的变化情况，并比较不同民族间各项指标的变化情况。结果利拉鲁肽＋盐酸二甲双胍组肥胖 T2DM 患者治疗后3、6个月时的 BMI、HBA1c、WHR、空腹血糖及餐后2 h 血糖较治疗前均下降，且下降的幅度高于盐酸二甲双胍组，差异具有统计学意义（P ＜0．05）；利拉鲁肽＋二甲双胍组肥胖 T2DM 患者治疗后3、6个月时的收缩压／舒张压、低密度脂蛋白较治疗前均有所下降，但下降幅度偏小，两组比较差异无统计学意义（P ＞0．05）。利拉鲁肽＋盐酸二甲双胍组维吾尔族患者治疗后3、6个月时的 BMI、HBA1c、WHR、空腹血糖及餐后2 h 血糖较治疗前均下降，且下降的幅度大于汉族患者，差异具有统计学意义（P ＜0．05）。结论利拉鲁肽联合盐酸二甲双胍在降低肥胖 T2DM 患者的 BMI、HBA1c、WHR、空腹血糖及餐后2 h 血糖要优于单用二甲双胍，可作为肥胖 T2DM 患者的优选治疗方案；利拉鲁肽联合二甲双胍治疗方案对维吾尔族肥胖 T2DM 患者效果明显，可作为其降糖的优先治疗方案。%Objective Observation of clinical effects of liraglutide combined with mefformin on type 2 diabe-tes mellitus with obesity.Methods The randomized and controlled open-label trial involved 132 patients with obesity and type 2 diabetes,who were randomly assigned to groups of receiving Liraglutide combined with mefformin (n =66,uygur=21,han=45)or mefformin alone (n =66,uygur=29,han=37)for 24 weeks.The changes of BMI,HBA1c,waist-hip ratio,fasting glucose treatment,postprandial blood sugar 2 hours,systolic/diastolic blood pressure and low density lipoprotein cholesterol before the treatment and after treatment of 3 months or 6 months were compared.And,the indexes above of different nationalities were compared too.Results After treatment for 3 months or 6 months,BMI,HBA1c,waist-hip ratio, fasting glucose treatment and postprandial blood sugar 2 hours of the experimental group were decreased than that of the control group (P <0.05).The systolic/diastolic blood pressure and low density lipoprotein cholesterol (hdl-c)of experimental group were declined,but the small decline compared with that of the control group and no statistical difference (P >0.05).After treatment,the BMI,HBA1c,waist-hip ratio, fasting glucose treatment,postprandial blood sugar 2 hours of Uygur was improved greater than that of the Han (P <0.05).Conclusion The effects of Liraglutide combined with mefformin is superior to met-formin only,and could be used as optimization of obese patients with T2DM treatment,and especially for the Uygur.
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