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投稿时间：2023-05-02 网络发布日期：2023-12-20
投稿时间：2023-05-02 网络发布日期：2023-12-20
中文摘要: 目的 探讨利拉鲁肽在2型糖尿病（T2DM）急性脑梗死患者中的疗效，及其对患者神经功能及血清血管内皮生长因子（VEGF）、碱性成纤维细胞生长因子（bFGF）的影响。
方法将2020年3月至2022年3月海口市人民医院收治的160例伴T2DM的急性脑梗死患者随机分为观察组和对照组，各80例。两组患者均给予脑梗死急性期常规治疗，在此基础上对照组应用门冬胰岛素和甘精胰岛素控制血糖，观察组应用利拉鲁肽和甘精胰岛素控制血糖，两组均连续治疗3个月。比较两组患者临床疗效，治疗前后空腹血糖（FBG）、餐后2 h血糖（2hPG）、糖化血红蛋白（HbA1c）、胰岛素抵抗指数（HOMA-IR）、美国国立卫生研究院卒中量表（NIHSS）及改良Rankin量表（mRS）评分。应用酶联免疫吸附法检测两组治疗前及治疗1个月、3个月血清VEGF和bFGF水平。
结果 治疗后观察组FBG、bFGF、HbA1c、HOMA-IR水平、NIHSS及mRS评分均较治疗前降低，且治疗后观察组上述指标水平均显著低于对照组（P＜0.05）。观察组临床总有效率显著高于对照组［95.00%(76/80) vs 83.75%(67/80)， χ2=5.331，P=0.021］。两组治疗后血清VEGF、bFGF水平均呈逐渐下降趋势（P＜0.05），治疗1个月、3个月观察组血清VEGF和bFGF水平均显著高于对照组（P＜0.05）。
结论 利拉鲁肽联合甘精胰岛素治疗T2DM急性脑梗死患者，能有效控制血糖，减少胰岛素抵抗，减轻患者神经功能损伤，上调血清VEGF和bFGF水平，提高临床疗效。
Abstract:Objective To investigate the therapeutic effect of liraglutide on acute cerebral infarction (ACI) in patients with type 2 diabetes mellitus (T2DM), and its effect on neurological function and serum vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF).
Methods A total of 160 patients with ACI accompanied by T2DM admitted to Haikou People's Hospital from March 2020 to March 2022 were randomly divided into observation group and control group (n=80, each). Both groups of patients were given routine treatment for ACI. On this basis, the control group was treated with insulin aspart and insulin glargine, while the observation group was treated with liraglutide and insulin glargine. Both groups received continuous treatment for 3 months. In addition to clinical efficacy, fasting blood glucose (FBG) before and after treatment, 2-hour postprandial blood glucose (2hPG), hemoglobin A1c (HbA1c), insulin resistance index (HOMA-IR), National Institutes of Health Stroke Scale (NIHSS), and modified Rankin Scale (mRS) scores of two groups of patients was compared. Enzyme linked immunosorbent assay was used to detect the levels of serum VEGF and bFGF before treatment and after 1 and 3 months of treatment in both groups.
Results After treatment, the levels of FBG, bFGF, HbA1c, HOMA-IR, and the scores of NIHSS and mRS in the observation group decreased compared to those before treatment, and the above indicators levels in the observation group were significantly lower than those in the control group (P＜0.05). The total clinical effective rate of the observation group was significantly higher than that of the control group ［95.00%(76/80) vs 83.75%(67/80), χ2=5.331, P=0.021］. After treatment, the levels of serum VEGF and bFGF showed a gradual downward trend in both groups (P＜0.05). After 1 month and 3 months of treatment, the serum VEGF and bFGF levels in the observation group were significantly higher than those in the control group (P＜0.05).
Conclusion Liraglutide combined with insulin glargine can effectively control blood sugar, reduce insulin resistance, alleviate neurological damage, upregulate serum VEGF and bFGF levels, and improve clinical efficacy in T2DM patients with ACI.
keywords: Acute cerebral infarction Liraglutide Insulin glargine Insulin aspart Neurological function Type 2 diabetes Vascular regeneration Vascular endothelial growth factor Basic fibroblast growth factor Insulin resistance
文章编号： 中图分类号：R587.1 R743.3 文献标志码：A
基金项目:海南省卫生健康行业科研项目（21A200272）
附件
| Author Name | Affiliation |
| SUN Rongdao, YANG Guoshuai, ZHANG Jiangshan, HU Yujie | Neurology Department, Haikou? People's Hospital, Haikou, Hainan 570208, China |
引用文本：
孙荣道，杨国帅，张江山，胡裕杰.利拉鲁肽对2型糖尿病急性脑梗死患者神经功能及血清VEGF和bFGF水平的影响[J].中国临床研究,2023,36(12):1793-1797,1802.
孙荣道，杨国帅，张江山，胡裕杰.利拉鲁肽对2型糖尿病急性脑梗死患者神经功能及血清VEGF和bFGF水平的影响[J].中国临床研究,2023,36(12):1793-1797,1802.