2025 年第 2 期 第 20 卷

2型糖尿病患者采用度拉糖肽联合双歧杆菌四联活菌片治疗对降低心血管病发生风险的价值研究

Study on the value of dulaglutide combined with Bifidobacterium quadruple live bacterial tablets in reducing the risk of cardiovascular disease in patients with type 2 diabetes mellitus

作者：田金霞杨燕飞于子娟宗晓春

英文作者：Tian Jinxia Yang Yanfei Yu Zijuan Zong Xiaochun

单位：河北省张家口市第一医院内分泌科，张家口075000

英文单位：Department of Endocrinology Zhangjiakou First Hospital Hebei Province Zhangjiakou 075000 China

关键词：度拉糖肽；双歧杆菌四联活菌片；2型糖尿病；心血管病发生风险

英文关键词：Dulaglutide;Bifidobacteriumquadruplelivebacterialtablets;Type2diabetesmellitus;Cardiovasculardiseaserisk

• 摘要：

• 目的 探讨度拉糖肽联合双歧杆菌四联活菌片治疗2型糖尿病（T2DM）对降低心血管病发生风险的价值。方法 选取2021年3月至2022年3月河北省张家口市第一医院内分泌科收治的60例T2DM患者作为研究对象，按照随机数字表法分为对照组和观察组，各30例。对照组采用常规药物治疗，观察组在对照组的基础上加用度拉糖肽联合双歧杆菌四联活菌片进行治疗，2组均接受饮食及运动干预。检测2组患者血糖水平、胰岛功能指标、炎症因子指标，比较2组心血管病的发生风险。结果 治疗后，2组患者的空腹血糖、糖化血红蛋白及平均血糖水平均低于治疗前，且观察组血糖水平均低于对照组（均P＜0.05）。治疗后，2组患者的稳态模型胰岛β细胞功能指数、0.5 h胰岛素生成指数、2 h胰岛素生成指数均高于治疗前，稳态模型胰岛素抵抗指数均低于治疗前，且与对照组相比，观察组变化幅度更大（均P＜0.05）。治疗后，2组患者的白细胞介素6、高敏C反应蛋白、脂多糖水平均低于治疗前，且观察组各指标水平均低于对照组（均P＜0.05）。观察组治疗后Framingham危险评分及心血管病10年风险均低于治疗前，且低于对照组［（12.0±0.6）分比（13.1±0.8）分、（4.1±2.3）%比（6.2±5.3）%］（均P＜0.05）。结论 度拉糖肽联合双歧杆菌四联活菌片治疗T2DM，可减轻胰岛素抵抗，改善胰岛β细胞功能，控制炎症反应，降低心血管事件发生风险。

• Objective To explore the value of dulaglutide combined with Bifidobacterium quadruple live bacterial tablets in reducing the risk of cardiovascular diseases in patients with type 2 diabetes mellitus (T2DM). Methods A total of 60 patients with T2DM admitted to the Department of Endocrinology, Zhangjiakou First Hospital, Hebei Province from March 2021 to March 2022 were selected as the research objects. According to the random number table method, they were divided into control group and observation group, with 30 cases in each group. The control group was treated with conventional drugs, and the observation group was treated with dulaglutide combined with Bifidobacterium quadruple live bacterial tablets on the basis of the control group. Both groups received diet and exercise intervention. The blood glucose level, islet function index and inflammatory factor index of the two groups were detected, and the risk of cardiovascular disease was compared between the two groups. Results After treatment, the fasting blood glucose, glycosylated hemoglobin and average blood glucose levels of the two groups were lower than those before treatment, and the blood glucose level of the observation group was lower than that of the control group (all P＜0.05). After treatment, the steady-state model islet β cell function index, 0.5 h insulin production index and 2 h insulin production index of the two groups were higher than those before treatment, and the steady-state model insulin resistance index was lower than that before treatment; compared with the control group, the observation group had greater changes (all P＜0.05). After treatment, the levels of interleukin-6, high-sensitivity C-reactive protein and lipopolysaccharide in the two groups were lower than those before treatment, and the levels of each index in the observation group were lower than those in the control group (all P＜0.05). After treatment, the Framingham risk score and 10-year risk of cardiovascular disease in the observation group were lower than those before treatment, and lower than those in the control group ［(12.0±0.6) vs (13.1±0.8), (4.1±2.3)% vs (6.2±5.3)%］(all P＜0.05). Conclusion Dulaglutide combined with Bifidobacterium quadruple live bacterial tablets in the treatment of T2DM can reduce insulin resistance, improve islet β cell function, control inflammatory response, and reduce the risk of cardiovascular events.