艾塞那肽对早期2型糖尿病肾病的疗效观察  

The clinic observation of exenatide therapy for patients with earlier type 2 diabetic nephropathy

作　　者：郑萌萌 钟兴[1] 杜益君[1] 王秀艳[1] 潘天荣[1] ZHENG Mengmeng;ZHONG Xing;DU Yijun;WANG Xiuyan;PAN Tianrong(Department of Endocrinae,The Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230601,China)

机构地区：[1]安徽医科大学第二附属医院内分泌科

出　　处：《安徽医药》2019年第7期1448-1451,共4页Anhui Medical and Pharmaceutical Journal

基　　金：安徽省高校自然科学研究项目(KJ2018A0202)

摘　　要：目的观察艾塞那肽对早期2型糖尿病肾病病人的临床疗效。方法选取2016年9月至2018年1月在安徽医科大学第二附属医院住院确诊为早期2型糖尿病肾病的病人60例,采用随机数字表法分为艾塞那肽组和对照组,每组各30例。对照组给予常规口服降糖药联合胰岛素治疗,艾塞那肽组给予常规口服降糖药联合艾塞那肽治疗。分别检测并比较两组治疗前及治疗20周后空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1c)、收缩压(SBP)、体质量指数(BMI)、三酰甘油(TG)、总胆固醇(TC)、血清肌酐(SCr)、随机尿白蛋白与肌酐比值(UACR)、血清胱抑素C(Cys C)。结果治疗20周后,两组FBG、2 h PG、Hb A1c、SBP水平均较治疗前降低(P<0.05),但组间比较,差异无统计学意义(P>0.05);艾塞那肽组治疗20周后BMI(26.88±2.59)kg/m^2、TG(1.88±0.62)mmol/L、TC(4.28±0.72)mmol/L、UACR(49.45±21.06)mg/g、Cys C(0.90±0.26)mg/L较治疗前BMI(28.74±3.37)kg/m^2、TG(2.49±0.92)mmol/L、TC(5.64±0.76)mmol/L、UACR(94.09±20.51)mg/g、Cys C(1.56±0.47)mg/L明显降低(P<0.05),且显著低于对照组[BMI(28.55±2.53)kg/m^2、TG(2.28±0.63)mmol/L、TC(5.13±0.97)mmol/L、UACR(75.12±10.72)mg/g、Cys C(1.38±0.39)mg/L](P<0.05)。结论艾塞那肽可减少早期2型糖尿病肾病病人尿白蛋白的排泄,延缓肾病进展。Objective To observe the clinical curative effect of exenatide on earlier type 2 diabetic nephropathy.Methods From September 2016 to January 2018,Sixty patients with early type 2 diabetic nephropathy were divided into the exenatide group(30 cases)and the control group(30 cases)by numerical random table method.The control group was given routine oral hypoglycemic drugs combined with insulin treatment,while the exenatide group was given routine oral hypoglycemic drugs combined with exenatide treatment.The fasting blood glucose(FBG)and postprandial 2 h blood glucose(2 h PG),glycosylated hemoglobin(Hb A1 c),systolic blood pressure(SBP),body mass index(BMI),triglycerides(TG),total cholesterol(TC),serum creatinine(Scr),the ratio of urinary albumin to creatinine(UACR)and serum cystatin C(Cys C)were respectively measured before treatment and after 20 weeks of treatment.Results After 20 weeks of treatment,the levels of FBG,2 h PG,Hb A1 c and SBP in both groups were reduced compared with those before treatment(P<0.05),and there was no significant difference between the two groups(P>0.05);BMI[(26.88±2.59)vs.(28.74±3.37)kg/m^2],TG[(1.88±0.62)vs.(2.49±0.92)mmol/L],TC[(4.28±0.72)vs.(5.64±0.76)mmol/L],UACR[(49.45±21.06)vs.(94.09±20.51)mg/g],Cys C[(0.90±0.26)vs.(1.56±0.47)mg/L]in exenatide group were significantly lower than before treatment(P<0.05),and significantly lower than the control group[BMI(28.55±2.53)kg/m^2,TG(2.28±0.63)mmol/L,TC(5.13±0.97)mmol/L,UACR(75.12±10.72)mg/g,Cys C(1.38±0.39)mg/L](P<0.05).Conclusion Exenatide can reduce urinary albumin excretion and delay the progression of nephropathy in patients with early type 2 diabetic nephropathy.

关 键 词：糖尿病肾病 2型 艾塞那肽 尿白蛋白与肌酐比值 

分 类 号：R587.2[医药卫生—内分泌]