本文關(guān)鍵詞： 長效GLP-1類似物 甘精胰島素 2型糖尿病 Meta分析　出處：《重慶醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:評價長效GLP-1類似物與甘精胰島素治療血糖控制不佳的2型糖尿病人的療效性及安全性。方法:本文采用“胰高血糖素樣肽-1、艾塞那肽周制劑、阿必魯肽、杜拉糖肽與甘精胰島素”等檢索詞,檢索CNKI、CBM、VIP、萬方、Pubmed、Embase及Cochrane數(shù)據(jù)庫,檢索時間為建庫至2016年12月。按照入排標(biāo)準(zhǔn),篩選出在常規(guī)降糖藥物治療效果不佳的基礎(chǔ)上采用長效GLP-1類似物與甘精胰島素治療方案的療效性及安全性比較的研究,并提取相應(yīng)數(shù)據(jù)。評價結(jié)局指標(biāo)包括Hb A1c、FPG、2h PG、體重變化、低血糖、胃腸道反應(yīng)及局部注射反應(yīng)等。按Cochrane系統(tǒng)評價的方法對所納入文獻(xiàn)質(zhì)量進(jìn)行評估。應(yīng)用Revman 5.3軟件以WMD或RR為效應(yīng)量進(jìn)行綜合定量分析,采用I2值檢驗各研究間的異質(zhì)性,以0.05作為檢驗水準(zhǔn)。結(jié)果:最終納入6篇RCT,共計3112例患者。綜合數(shù)據(jù)分析結(jié)果顯示長效GLP-1類似物組與甘精胰島素組相比,Hb A1c、FPG、體重變化值分別為-0.23%(95%CI:-0.43~-0.02,P0.05)、0.73mmol/L(95%CI:0.13~1.32,P0.05)、-2.49kg(95%CI:-3.25~-1.73,P0.05);該組藥物胃腸道反應(yīng)(RR:3.18,95%CI:2.42~4.17,P0.05)及局部注射反應(yīng)(RR:7.25,95%CI:3.01~17.48,P0.05)較常見,而低血糖(RR:0.62,95%CI:0.43~0.89,P0.05)及嚴(yán)重低血糖事件(RR:0.47,95%CI:0.22~0.99,P=0.05)發(fā)生率低。同樣,胰腺炎、甲狀腺腫瘤及嚴(yán)重心血管事件發(fā)生率極低。結(jié)論:長效GLP-1類似物可有效控制血糖、改善體重、降低低血糖發(fā)生率。但二者在2型糖尿病患者應(yīng)用的長期療效性及安全性比較有待于研究周期更長的臨床試驗來驗證。
[Abstract]:Objective: to evaluate the efficacy and safety of long-acting GLP-1 analogues and insulin glargine in the treatment of type 2 diabetes patients with poor blood glucose control. Methods: "glucagon like peptide 1" was used in this study. The keywords of week preparation of Isenapeptide, Abiropeptide, Dula-glycopeptide and insulin glargine were searched. Embase and Cochrane database, the retrieval time is until December 2016. According to the entry standard. On the basis of the low efficacy of conventional hypoglycemic drugs, the efficacy and safety of long-term GLP-1 analogues and insulin glargine were compared. The outcome indexes included HbA1cFPGG 2h PG2, body weight change and hypoglycemia. Gastrointestinal reaction and local injection reaction. The quality of literature was evaluated by Cochrane system. Revman was used to evaluate the quality of the literature. 5.3 the effect quantity of WMD or RR was analyzed. I 2 value was used to test the heterogeneity of each study, and 0. 05 was taken as the test level. Results: 6 RCT articles were included. A total of 3112 patients were involved. Comprehensive data analysis showed that the long-acting GLP-1 analogue group was compared with insulin glargine group. The weight change values were -0.23 and 95, respectively, and CI: -0.43% -0.02% P0.05 / 0.73 mmol / L ~ (95) CI: 0.13 / 1.32. P0.05 ~ 2.49 kg ~ (95) CI: -3.25 ~ (-1.73) P0.05; The Gastrointestinal reaction of this group was as follows: RR: 3.1895 CI: 2.42 4.17 P0.05) and local injection reaction RR: 7.25. 95 CI: 3.01 / 17.48 (P0.05), while hypoglycemia is more common than R: 0.6295 CI: 0.430.89. P 0.05) and severe hypoglycemia events RR: 0.47 / 95 CI: 0.220.0.99p 0.05. similarly, pancreatitis was found in the patients with severe hypoglycemia (P < 0.05) and severe hypoglycemia events (RR: 0.47 / 95). The incidence of thyroid neoplasms and severe cardiovascular events is very low. Conclusion: Long-term GLP-1 analogues can effectively control blood glucose and improve body weight. To reduce the incidence of hypoglycemia, however, the long-term efficacy and safety of the two methods in type 2 diabetes need to be verified in clinical trials with a longer study period.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R587.1

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