李粮　赵凡　陈翠娟　赵海桃

【摘要】 目的：探讨利拉鲁肽对2型糖尿病患者认知功能及胰岛素使用量的影响，并探讨可能机制。方法：选择2018年1-2019年6月就诊于江门市人民医院内分泌科的2型糖尿病患者118例，随机分为对照组和利拉鲁肽组。对照组给予门冬胰岛素30治疗进行胰岛素强化治疗，利拉鲁肽组在对照组基础上皮下注射利拉鲁肽0.6 U，1周后改为1.2 U，两组均治疗12周。比较两组治疗前后BMI、FBG、2 h PG、HbA1c、MoCA评分、胰岛素使用剂量。结果：治疗前两组BMI、FBG、2 h PG、HbA1c、MoCA评分、胰岛素用量比较差异无统计学意义（P>0.05），治疗后利拉鲁肽组BMI、FBG、2 h PG、HbA1c、胰岛素用量均低于对照组，MoCA评分高于对照组，差异均有统计学意义（P<0.05）。结论：利拉鲁肽在降糖的同时可降低胰岛素的使用量，并改善2型糖尿病患者的认知功能。

【关键词】 利拉鲁肽 2型糖尿病 认知功能 轻度认知功能损害

doi：10.14033/j.cnki.cfmr.2020.18.008 文献标识码 B 文章编号 1674-6805（2020）18-00-03

Effect of Liraglutide on Blood Glucose and Cognitive Function in Patients with Type 2 Diabetes/LI Liang， ZHAO Fan， CHEN Cuijuan， ZHAO Haitao. //Chinese and Foreign Medical Research， 2020， 18（18）： -20

[Abstract] Objective： To investigate the effect of Liraglutide on cognitive function and insulin use in patients with type 2 diabetes mellitus， and to explore the possible mechanism. Method： From January 2018 to June 2019， 118 patients with type 2 diabetes were selected from the Department of Endocrinology，  Peoples Hospital of Jiangmen. They were divided into the control group and the Liraglutide group. The control group was treated with Asparagine Insulin 30 for intensive insulin treatment. On the basis of the treatment in the control group， the Lialulutide group was injected with 0.6 U of lialulutide， and changed to 1.2 U after 1 week. Both groups were treated for 12 weeks. The BMI， FBG， 2 h PG， HbA1c， insulin dosage and MoCA scores were compared before and 12 weeks after observation. Result： Before treatment， there were no statistically significant differences in BMI， FBG， 2 h PG， HbA1c， MoCA score and Insulin dosage between the two groups （P>0.05）. After treatment， the BMI， FBG， 2 h PG， HbA1c， insulin dosage in the Lialurutin group were all lower than those in the control group， and MoCA score was higher than that in the control group， the differences were statistically significant （P<0.05）. Conclusion： Liraglutide can reduce the use of Insulin and improve the cognitive function of patients with type 2 diabetes mellitus.

[Key words]Liraglutide Type 2 diabetes Cognitive function Mild cognitive impairment

First-authors address： Peoples Hospital of Jiangmen City， Jiangmen 529020， China

2型糖尿病（type 2 diabetes mellitus，T2DM）與轻度认知功能损害（mild cognitive impairment，MCI）发生密切相关，主要表现为语言、学习等能力为主的轻中度认知功能受损，进一步恶化可发展为痴呆。2型糖尿病是MCI和阿尔茨海默病（Alzheimer disease，AD）重要的独立危险因素，且糖尿病患者可加速认知功能下降速度，较非糖尿病者更快进展为痴呆，严重影响患者生活质量。早期发现并干预2型糖尿病患者的认知功能障碍，具有重要的意义[1]。利拉鲁肽是一种新一代人工合成的降糖药，为GLP-1类似物，体内及体外试验证实能调节神经细胞的分化和增殖，并改善胰岛素抵抗及AD模型动物的认知功能。有研究发现经过利拉鲁肽治疗6个月后AD患者认知功能明显提高[2]。因此，利拉鲁肽一定程度上可影响T2DM患者认知障碍的发生、发展。本研……