艾塞那肽治疗早期糖尿病肾病患者的疗效研究  

Effects of exenatide on patients with early diabetic nephropathy

作　　者：莫泽纬[1] 陈道雄[1] 高勇义[1] 全会标[1] 陈存仁[1] 王斐[1] 张华川[1] MO Zewei CHEN Daoxiong GAO Yongyi QUAN Huibiao CHEN Cunren WANG Fei ZHANG Huachuan(Department of Endocrinology, Hainan Provincial People＇s Hospital, Haikou, Hainan 570311, China)

机构地区：[1]海南省人民医院内分泌科,海南海口570311

出　　处：《中国热带医学》2017年第7期714-717,共4页China Tropical Medicine

基　　金：海南省卫计委医学科研项目(No.14A200064)

摘　　要：目的观察艾塞那肽对2型糖尿病合并早期糖尿病肾病(diabetic nephropathy,DN)患者肾功能等临床指标的影响。方法 58例早期DN患者随机分为艾塞那肽组与格列美脲组,每组各29例,分别给予艾塞那肽和格列美脲治疗,两组均联合二甲双胍治疗。治疗24周后对比两组患者空腹血糖(fasting plasma glucose,FPG)、餐后2 h血糖(2 hpostprandial plasma glucose,2 h PG)、糖化血红蛋白(hemoglobin Alc,Hb A1c)、血脂、尿素(blood urea,BUN)、肌酐(creatinine,Cr)、尿白蛋白/肌酐比值(urinary albumin to creatinine ratio,UACR)、血清转化生长因子-β1(transforming growthfactorβ1,TGF-β1)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、体重、体重指数(body mass index,BMI)等变化。结果 24周治疗后,两组FPG、2 h PG、Hb A1c水平均较治疗前降低(P<0.05),组间比较差异无统计学意义(P>0.05);两组UACR均较治疗前降低(P<0.05);艾塞那肽组体重、BMI、SBP较治疗前降低(P<0.05),24周治疗后,艾塞那肽组UACR、TGF-β1、SBP、体重、BMI较格列美脲组降低(P<0.05)。结论艾塞那肽通过降低血糖、血压,减轻体重,减少尿蛋白排泄及抗纤维化作用保护肾脏。Objective To evaluate the effects of exenatide on patients with type two daibetes and early diabeticnephropathy（DN）.Methods A total of 58 patients with DN were randomly divided into exenatide group and glimepiridegroup,29 patients in each group,both groups were combined with metformin.Fasting plasma glucose（FPG）,2 h postprandialplasma glucose（2 h PG）,hemoglobin Alc（Hb A1c）,lipids,blood urea（BUN）,creatinine（Cr）,urinary albumin to creatinine ratio（UACR）,transforming growth factor-β1（TGF-β1）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,body weightand body mass index（BMI） were compared between the two groups after 24 weeks treatments.Results After the 24 weekstreatments,the levels of FPG,2 h PG and Hb A1 c in the both groups were lower than those before treatment（P〈0.05）,and therewas no significant difference between the two groups（P〉0.05）.UACR in both groups was lower than before treatment（P〈0.05）.TGF-β1,UACR,SBP,body weight and BMI in group Exe were significantly lower than those in group Glm（P〈0.05）.Conclusions Exenatide may protect daibetic nephropathy by lower blood glucose,blood pressure and weight,reduce urinaryprotein excretion and anti-fibrosis effect.

关 键 词：糖尿病肾病 艾塞那肽 格列美脲 尿白蛋白/肌酐比值 血清转化生长因子-Β1 

分 类 号：R587.1[医药卫生—内分泌]