利拉鲁肽联合替米沙坦治疗糖尿病肾病患者的临床研究  

Clinical trial of liraglutide combined with telmisartan in the treatment of patients with diabetic nephropathy

作　　者：魏燕[1] 金剑虹[1] 侯鹏超[1] WEI Yan;JIN Jian-hong;HOU Peng-chao(Department of Endocrinology and Metabolism,Hangzhou Hospital of Traditional Chinese Medicine,Hangzhou 310009,Zhejiang Province,China)

机构地区：[1]杭州市中医院内分泌代谢科,浙江杭州310009

出　　处：《中国临床药理学杂志》2020年第2期106-109,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察利拉鲁肽联合替米沙坦对糖尿病肾病患者转化生长因子-β1(TGF-β1)和尿蛋白与肌酸酐比值(UACR)的影响。方法将我院内分泌科收治的56例糖尿病肾病患者随机分为试验组和对照组,每组28例。2组均给予替米沙坦口服治疗,初始剂量为每次40 mg,每天1次,若血压控制不理想,可逐渐加大至最大剂量每次80 mg,每天1次,持续2个月。对照组在此基础上给予百令胶囊,每次2 g,每天1次,口服,持续2个月。试验组在此基础上给予利拉鲁肽,起始剂量为每天0.6 mg,每天1次,1周后增加至每天1.2 mg,每天1次,可逐渐增加至最大每天1.8 mg,腹部注射,持续2个月。比较2组患者的炎症因子、血糖(Glu)、肾功能、UACR的水平和药物不良反应发生率。结果治疗后,试验组患者肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、TGF-β1、糖化血红蛋白(HbA1c)、空腹血糖(FBG)和餐后2 h血糖(2 h PBG)、UACR、尿酸(UA)和尿素氮(BUN)水平分别为(18.73±3.13)pg·mL^-1,(99.24±15.14)pg·mL^-1,(103.12±30.37)μg·mL^-1,(5.64±0.89)%,(6.23±1.23)mmol·L^-1,(8.41±1.32)mmol·L^-1,(142.12±49.25)mg·g^-1,(239.73±37.13)μmol·L^-1,(4.26±0.54)mmol·L-1,对照组分别为(23.36±4.81)pg·mL^-1,(125.45±24.69)pg·mL^-1,(128.76±35.17)μg·mL-1,(6.87±1.31)%,(8.47±1.34)mmol·L^-1,(10.18±1.53)mmol·L^-1,(172.43±45.46)mg·g^-1,(296.36±41.38)μmol·L^-1,(5.45±0.69)mmol·L^-1,差异均有统计学意义(均P<0.05)。试验组和对照组肾小球滤过率(GFR)分别为(62.12±10.37),(51.76±11.17)mL·min^-1(P<0.05)。试验组和对照组药物不良反应发生率分别为10.71%(3例/28例),17.86%(5例/28例),差异无统计学意义(P>0.05)。结论利拉鲁肽联合替米沙坦可以有效降低糖尿病肾病患者TGF-β1和UACR的水平,改善患者的肾功能,减缓了糖尿病肾病的进程。Objective To investigate the effects of liraglutide combined with telmisartan on transforming growth factor-β1(TGF-β1)and urinary protein to creatinine ratio(UACR)in patients with diabetic nephropathy.Methods Fifty-six patients with diabetic nephropathy were randomly divided into treatment group and control group,with 28 cases in each group.Both groups were treated with telmisartan orally(40 mg·time^-1 and 1 time·d^-1,if blood pressure control is not satisfactory,the maximum dose can be gradually increased to 80 mg·time^-1 and 1 time·d^-1 for 2 months.Control group was given Bailing capsule 2 g a time,1 time·d^-1 for 2 months.Treatment group was given liraglutide,0.6 mg·d^-1,1 time·d^-1,and increased to 1.2 mg·d^-1 after a week,1 time·d^-1,and gradually increased to the maximum of 1.8 mg·d^-1 for 2 months,abdominal injection.The levels of inflammatory factors,blood glucose,renal function and urinary albumin excretion and adverse drug reactions were compared in two groups.Results After treatment,the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),TGF-β1,glycosylated hemoglobin(HbA1c),fasting blood glucose(FBG),2 h postprandial blood glucose(PBG),UACR,uric acid(UA)and blood urea nitrogen(BUN)in treatment group were(18.73±3.13)pg·mL^-1,(99.24±15.14)pg·mL^-1,(103.12±30.37)μg·mL^-1,(5.64±0.89)%,(6.23±1.23)mmol·L^-1,(8.41±1.32)mmol·L^-1,(142.12±49.25)mg·g^-1,(239.73±37.13)μmol·L^-1,(4.26±0.54)mmol·L^-1,all had significant difference with those in control group were(23.36±4.81)pg·mL^-1,(125.45±24.69)pg·mL-1,(128.76±35.17)μg·mL^-1,(6.87±1.31)%,(8.47±1.34)mmol·L^-1,(10.18±1.53)mmol·L^-1,(172.43±45.46)mg·g^-1,(296.36±41.38)μmol·L^-1,(5.45±0.69)mmol·L^-1(all P<0.05).The levels of glomerular filtration rate(GFR)in treatment group and control group were(62.12±10.37),(51.76±11.17)mL·min^-1,with significant difference(P<0.05).The incidence of adverse drug reactions in treatment group and control group were 10.71%(3 cases/28 cases),17.86%(5 cases/28 cases),with

关 键 词：替米沙坦 利拉鲁肽 糖尿病肾病 糖化血红蛋白 肾功能 

分 类 号：R977[医药卫生—药品]