度拉糖肽联合达格列净对早期糖尿病肾病尿蛋白排泄率及血清炎性因子的影响  

Effect of dulaglutide combined with daggligin on urinary protein excretion rate and serum inflammatory factors in patients with early diabetic nephropathy

作　　者：邢建东[1] 姚艳琴[2] 王静茹 马春明[1] 陈海丽[1] 李银玉[1] Xing Jiandong;Yao Yanqin;Wang Jingru;Ma Chunming;Chen Haili;Li Yinyu(Department of Endocrinology,the Fifth People's Hospital of Datong,Shanxi Province,Datong 037000,China;不详)

机构地区：[1]山西省大同市第五人民医院内分泌科,037000 [2]山西省大同市第五人民医院影像科,037000

出　　处：《疑难病杂志》2022年第11期1158-1162,1168,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：大同市重点研发计划项目(2018082)。

摘　　要：目的观察度拉糖肽联合达格列净对早期糖尿病肾病尿蛋白排泄率及血清炎性因子的影响。方法选取2021年1—10月山西省大同市第五人民医院内分泌科诊治早期糖尿病肾病患者120例,按随机数字表法分为对照组和观察组,各60例。对照组患者给予达格列净治疗,观察组患者在对照组的基础上加用度拉糖肽治疗。比较2组患者治疗前后肾功能[肾小球滤过率(GFR)、尿素氮(BUN)、尿酸(UA)及尿蛋白排泄率]、炎性因子水平[转化生长因子-β_(1)(TGF-β_(1))、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、血糖水平[餐后2 h血糖(2 hPG)、空腹血糖(FPG)、糖化血红蛋白(HbA_(1c))]、血脂水平[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)],以及不良反应发生率。结果与治疗前比较,治疗后2组BUN、UA、尿蛋白排泄率均降低,GFR均升高,且观察组改善优于对照组(t=6.215、20.742、8.955、12.431,P均<0.001);治疗后2组血清TGF-β_(1)、IL-6、TNF-α均降低,且观察组低于对照组(t=12.139、18.351、13.889,P均<0.001);治疗后2组餐后2 h血糖、空腹血糖、糖化血红蛋白水平均降低,且观察组低于对照组(t=6.835、8.849、5.425,P均<0.001);治疗后2组血清TC、TG、LDL-C均降低,观察组HDL-C升高,且观察组改善优于对照组(t=4.225、15.746、4.243、4.121,P均<0.001);2组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论在达格列净治疗的基础上增加度拉糖肽,能有效减轻早期糖尿病肾病患者炎性反应,改善患者肾功能,调节血糖、血脂,且安全有效。Objective To observe the effect of dulaglutide combined with dagelin on urinary protein excretion rate and serum inflammatory factors in patients with early diabetic nephropathy.Methods From January to October 2021,120 patients with early diabetic nephropathy diagnosed and treated by the Department of Endocrinology of the Fifth People's Hospital of Datong,Shanxi Province,were selected and divided into the control group and the observation group according to the random number table method,with 60 patients in each group.The patients in the control group were treated with daggligin combined with telmisartan,and the patients in the observation group were treated with dulaglutide on the basis of the control group.The renal function[glomerular filtration rate(GFR),urea nitrogen(BUN),uric acid(UA)and urinary protein excretion rate]and the level of inflammatory factors[transforming growth factor-β_(1)(TGF-β_(1)),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],Blood glucose level(2h postprandial blood glucose,fasting blood glucose,glycosylated hemoglobin),blood lipid level[total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)]were compared between the two groups before and after treatment,and the incidence of adverse reactions.Results Compared with that before treatment,the excretion rates of BUN,UA,GFR and urinary protein in the two groups decreased after treatment,but the excretion rates of BUN,UA and urinary protein in the observation group were lower than those in the control group,and GFR was higher than those in the control group(t=6.215,20.742,8.955,12.431,P<0.001).Serum TGF-β_(1),IL-6,TNF-αof the two groups after treatment was lower in the observation group than in the control group(t=12.139,18.351,13.889,P<0.001).After treatment,the levels of blood glucose,fasting blood glucose and glycosylated hemoglobin at 2h after meal in both groups decreased,and those in the observation group were lower than those in the control group(t=6

关 键 词：糖尿病肾病 达格列净 度拉糖肽 替米沙坦 尿蛋白排泄率 炎性因子 

分 类 号：R587.2[医药卫生—内分泌]