摘要目的观察胰高血糖素样肽-1（GLP-1）受体激动剂对2型糖尿病合并阿尔茨海默病患者认知功能的影响。方法将2014年5月～2015年5月来我院就诊的2型糖尿病合并阿尔茨海默病的60例患者随机分为治疗组（30例）和对照组（30例），治疗组在常规降糖、降压、降脂治疗基础上，加用GLP-1受体激动剂——利拉鲁肽，对照组患者接受常规降糖、降压、降脂治疗的基础上加用空白安慰剂，两组患者血糖控制目标：空腹血糖（FPG）＜6.1mmol/L，餐后2小时血糖（2 h PG）＜10.0mmol/L，糖化血红蛋白（HbA1c）＜7%，治疗6个月后，采用简易智力状态检查量表（MMSE）评估两组患者治疗前后的认识功能的变化。结果治疗后，两组患者的FPG、2 h PG、HbA1c较治疗前均显著下降（P＜0.05），且均达标。治疗6个月后，治疗组MMSE评分较治疗前显著升高（P＜0.05），对照组患者的MMSE评分显著下降（P＜0.05），且治疗组的MMSE评分情况显著优于对照组（P＜0.05）。结论2型糖尿病合并阿尔茨海默病患者给予GLP-1受体激动剂能够显著改善患者的认知功能。
Abstract：Objective To observe the influence of glucagon-like peptide-1 （GLP-1）receptor agonist on the cognitive function in patients with type 2 diabetes complicated with Alzheimer disease. Methods Sixty patients with type 2 diabetes and Alzheimer disease from May 2014 to May 2015 visited our hospital were selected and evenly divided into treatment group and control group in random.In treatment group，on the basis of conventional therapies of blood glucose-reducing，depressurization，and lipid-lowering，GLP-1 receptor stimulant was added，while in control group，on the basis of regular therapies of reducing blood glucose，pressure，and lipid，blank placebo was added.The target of blood control in both groupswere fasting blood-glucose（FPG）was less than 6.1mmol/L，2-hour post-meal blood glucose（2 h PG）was less than 10.0 mmol/L，and glycosylated hemoglobin （HbA1c）was lower than 7%.After the treatment of 6 months，the scale ofmini-mental state examination（MMSE）was used to evaluate the change of cognitive function before and after therapy in the two groups.Results After therapy，FPG，2 h PG and HbA1c were greatly decreased in comparison with before treatment in two groups（P＜0.05），which were allmet the standard.After the treatment of 6months，MMSE score in treatment group was remarkably increased（P＜0.05），while MMSE score in control group was decreased greatly（P＜0.05）. MMSE score in treatment group was obviously superior to that in control group （P＜0.05）.Conclusion GLP-1 receptor stimulant can effectively improve cognitive function in patientswith type 2 diabetes combining with Alzheimer disease.
洪世华;吴菊琴;方向南;柯瑞琼;吕维名. GLP-1受体激动剂对2型糖尿病合并阿尔茨海默病患者认知功能的影响[J]. 中国当代医药, 2016, 23(29): 60-62.
HONG Shi-hua;WU Ju-qin;FANG Xiang-nan;KE Rui-qiong;LVWei-ming. Influence of GLP-1 receptor stimulant on the cognitive function in patients with type 2 diabetes com p licated with A lzheimer disease. 中国当代医药, 2016, 23(29): 60-62.
McKhann GM，Knopman DS，Chertkow H，et al.The diagnosis of dementia due to Alzheimer′s disease：recommendations from the National Institute on Aging-Alzheimer′s Association workgroups on diagnostic guidelines for Alzheimer's disease［J］.Alzheimer′s Dement，2011，7（3）：263-269.
［11］
Watson GS，Craft S.Modulation ofmemory by insulin and glucose：neuropsychologicalobservations in Alzheimer′s disease［J］.Eur JPharmacol，2004，490（1-3）：97-113.
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