探讨利拉鲁肽联合阿法骨化醇治疗老年2型糖尿病合并骨质疏松患者的疗效。

选择2018年6月至2020年3月四川省广元市中心医院收治的老年2型糖尿病合并骨质疏松患者67例。在常规降糖治疗、口服碳酸钙D3、饮食及运动干预的基础上，使用阿法骨化醇治疗33例（对照组），使用利拉鲁肽联合阿法骨化醇治疗34例（观察组）。比较两组的临床疗效、血糖控制情况、骨密度及骨代谢指标、不良反应发生情况。计量资料的比较采用t检验，计数资料的比较采用χ²检验。

观察组治疗后临床有效率明显高于对照组（χ²=7.309，P<0.05）。治疗后，两组糖化血红蛋白、空腹血糖、餐后2 h血糖以及钙、碱性磷酸酶、骨密度、骨保护蛋白、艾帕素13、β胶原片段均明显改善（观察组：t=5.563、10.017、3.589、8.776、2.582、2.986、7.316、4.590、13.914，对照组：t=2.333、2.135、2.523、4.864、2.291、2.625、4.581、2.277、8.863，P<0.05），其中观察组改善情况较对照组更明显（t=5.076、6.757、2.942、4.905、2.204、2.455、2.625、2.576、6.014，P<0.05）。两组患者不良反应总发生率的差异无统计学意义（χ²=0.001，P>0.05）。

利拉鲁肽联合阿法骨化醇治疗老年2型糖尿病合并骨质疏松患者的效果显著，能够提高患者的血糖控制水平，改善患者的骨密度及骨代谢指标。

To observe the efficacy of liraglutide combined with alfacalccitol in the treatment of elderly patients with type 2 diabetes mellitus (T2DM) complicated with osteoporosis.

A total of 67 elderly T2DM patients with osteoporosis admitted to Guangyuan Central Hospital from June 2018 to March 2020 were selected and randomly divided into control group (33 cases) and experimental group (34 cases). Both groups received conventional hypoglycemic treatment, oral calcium carbonate D3 therapy, diet and exercise intervention. Besides, the control group was treated with alfacalccitol, and the experimental group was treated with liraglutide combined with alfacalccitol. Clinical efficacy, blood glucose control, bone mineral density and bone metabolism indexes, and adverse reactions were compared between the two groups. T test was used to compare the measurement data, and χ² test was used to compare the count data.

The effective rate of experimental group was higher than that of control group (χ²=7.309, P < 0.05). Blood glucose control indicators like glycosylated hemoglobin, fasting blood glucose, 2-hour postprandial blood glucose, as well as bone mineral density and bone metabolism indicators like calcium, alkaline phosphatase, bone mineral density, osteoprotegerin, epoetin 13 and β collagen fragments, were all improved in both groups after treatment (observation group: t=5.563, 10.017, 3.589, 8.776, 2.582, 2.986, 7.316, 4.590, 13.914; control group: t=2.333, 2.135, 2.523, 4.864, 2.291, 2.625, 4.581, 2.277, 8.863; P < 0.05), and the experimental group showed significantly better improvement than the control group (t=5.076, 6.757, 2.942, 4.905, 2.204, 2.455, 2.625, 2.576, 6.014; P < 0.05). There was no significant difference in the total incidence of adverse reactions between two groups (χ²=0.001, P > 0.05).

Liraglutide combined with alfacalccitol has a significant effect on elderly patients with T2DM complicated with osteoporosis, which can improve blood glucose control, bone mineral density and bone metabolism, and is worthy of clinical application.