目的 采用網(wǎng)狀Meta分析比較德谷門冬胰島素、德谷胰島素利拉魯肽和甘精胰島素利司那肽治療2型糖尿病的療效和安全性。方法 檢索國內(nèi)外數(shù)據(jù)庫（數(shù)據(jù)庫創(chuàng)建時間到2024年9月18日），納入德谷門冬胰島素、德谷胰島素利拉魯肽、甘精胰島素利司那肽與基礎(chǔ)胰島素相互比較的隨機對照試驗。以糖化血紅蛋白＜7%人數(shù)、糖化血紅蛋白、體質(zhì)量、空腹血糖和低血糖人數(shù)為結(jié)局指標。采用R語言貝葉斯方法進行網(wǎng)狀Meta分析，繪制兩兩比較的聯(lián)賽圖，并通過計算累積排序概率圖下面積（SUCRA）進行排序。結(jié)果 最終納入25項隨機對照試驗。德谷胰島素利拉魯肽增加糖化血紅蛋白＜7%患者比例、降低糖化血紅蛋白、減輕體質(zhì)量、降低低血糖時間的發(fā)生風險的效果最好。甘精胰島素利司那肽與基礎(chǔ)胰島素相比，可以增加糖化血紅蛋白＜7%的人數(shù)、降低糖化血紅蛋白和減輕體質(zhì)量。從排序結(jié)果來看，德谷胰島素利拉魯肽在改善糖化血紅蛋白＜7%的人數(shù)、糖化血紅蛋白、體質(zhì)量、空腹血糖和低血糖風險上更優(yōu)。結(jié)論 德谷胰島素利拉魯肽具有改善糖化血紅蛋白、降低體質(zhì)量的療效優(yōu)勢，同時具有降低低血糖風險的安全性優(yōu)勢。

Objective To compare the efficacy and safety among insulin degludec and insulin aspart (IDegAsp), insulin degludec and liraglutide (IDegLira), and insulin glargine and lixisenatide (iGlarlixi) in treatment of type 2 diabetes by network Meta‐analysis. Methods Domestic and foreign database were comprehensively searched to identify randomized controlled trials (RCTs) of effects of IDegAsp, IDegLira, and iGlarlixi from inception to July 18, 2024. The outcomes were the achieving an HbA1c < 7%, HbA1c, body weight, fasting plasma glucose, and incidence of hypoglycaemia. R software was used to conduct Bayesian network Meta‐analysis and drawing the league map of pairwise comparison. The ranking probabilities of all treatments on efficacy and safety outcomes were displayed on their surface under the cumulative ranking (SUCRA) probabilities. Results A total of 25 RCTs were included in the analysis. IDegLira had the best effect on increasing the proportion of patients with HbA1c < 7%, reducing glycated hemoglobin, reducing body weight, and lowering the incidence of hypoglycemia. IGlarlixi was superior to basal insulin in achieving an HbA1c<7%, decreasing HbA1c, and losing body weight. According to the ranking results, IDegLira might better in achieving an HbA1c<7%, decreasing HbA1c and fasting plasma glucose, losing body weight and reducing incidence of hypoglycaemia. Conclusion IDegLira has therapeutic advantages in improving HbA1c and reducing body weight, while also having safety advantages in reducing the risk of hypoglycemia.

R977