利拉鲁肽联合氯沙坦对早期2型糖尿病肾病患者肾脏血流动力学、IGF-1、NF-κB、MCP-1水平的影响  

Effects of liraglutide combined with losartan on renal hemodynamics,IGF-1,NF-κB and MCP-1 levels of patients with early type 2 diabetic kidney disease

作　　者：梁云 王杰 雷烨 LIANG Yun;WANG Jie;LEI Ye(the People's Hospital of Sanyuan County,Xianyang 713800;Xi'an Daxing Hospital,Xi'an 710016;the Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,China)

机构地区：[1]三原县人民医院,陕西咸阳713800 [2]西安大兴医院,陕西西安710016 [3]陕西中医药大学第二附属医院,陕西咸阳712000

出　　处：《临床医学研究与实践》2022年第34期53-57,共5页Clinical Research and Practice

基　　金：陕西省中医管理局中医药科研课题(No.LCMS051)。

摘　　要：目的探讨利拉鲁肽联合氯沙坦对早期2型糖尿病肾病患者肾脏血流动力学、胰岛素样生长因子-1(IGF-1)、核因子-κB(NF-κB)、人单核细胞趋化蛋白-1(MCP-1)水平的影响。方法选取2019年2月至2021年3月我院收治的80例早期2型糖尿病肾病患者作为研究对象,按照随机数字表法将其分为对照组和观察组,各40例。对照组给予氯沙坦治疗,观察组给予氯沙坦联合利拉鲁肽治疗。比较两组的糖代谢指标、肾脏血流动力学指标、IGF-1、NF-κB、MCP-1水平、胰岛素抵抗指标及肾功能指标。结果治疗后,观察组的空腹血糖(FPG)、餐后2 h血糖(2 h PG)水平及糖化血红蛋白(HbA1c)低于对照组(P<0.05)。治疗后,观察组的平均流速、舒张期最小血流速度(V_(min))、收缩期最大血流速度(V_(max))高于对照组,搏动指数(PI)、阻力指数(RI)、V_(max)/V_(min)低于对照组(P<0.05)。治疗后,观察组的IGF-1、NF-κB、MCP-1水平低于对照组(P<0.05)。治疗后,观察组的胰岛素抵抗指数(HOMA-IR)低于对照组,胰岛β细胞功能指数(HOMA-β)、胰岛素敏感指数(ISI)高于对照组(P<0.05)。治疗后,观察组的血尿素氮(BUN)、血肌酐(Scr)、红细胞(RBC)水平低于对照组,白蛋白(Alb)水平高于对照组(P<0.05)。结论利拉鲁肽联合氯沙坦治疗早期2型糖尿病肾病可改善胰岛素抵抗,提高糖代谢指标控制效果,调节肾脏血流动力学及IGF-1、NF-κB、MCP-1水平,值得推广。Objective To explore the effects of liraglutide combined with losartan on renal hemodynamics,insulin-like growth factor-1(IGF-1),nuclear factor kappa-B(NF-κB)and monocyte chemoattractant protein-1(MCP-1)levels of patients with early type 2 diabetic kidney disease.Methods A total of 80 patients with early type 2 diabetic kidney disease admitted in our hospital from February 2019 to March 2021 were selected as the research objects,and the patients were divided into control group and observation group according to random number table method,with 40 cases in each group.The control group was treated with losartan,and the observation group was treated with liraglutide combined with losartan.The glucose metabolism indexes,renal hemodynamics indexes,the levels of IGF-1,NF-κB and MCP-1,insulin resistance indexes and renal function indexes of the two groups were compared.Results After treatment,the levels of fasting plasma glucose(FPG),2 hour postprandial plasam glucose(2 h PG)and glycated hemoglobin(HbA1c)in the observation group were lower than those in the control group(P<0.05).After treatment,the mean velocities,minimum diastolic blood flow velocity(V_(min))and maximal systolic flow velocity(V_(max))in the observation group were higher than those in the control group,and the pulsatility index(PI),resist index(RI)and V_(max)/V_(min) were lower than those in the control group(P<0.05).After treatment,the levels of IGF-1,NF-κB and MCP-1 in the observation group were lower than those in the control group(P<0.05).After treatment,the homeostasis model assessment of insulin resistance(HOMA-IR)in the observation group was lower than that in the control group,and the homeostasis model assessment ofβcell function index(HOMA-β)and insulin sensitivity index(ISI)were higher than those in the control group(P<0.05).After treatment,the levels of blood urea nitrogen(BUN),serum creatinine(Scr)and red blood cell(RBC)in the observation group were lower than those in the control group,and the level of albumin(Alb)was higher than that i

关 键 词：利拉鲁肽 氯沙坦 早期2型糖尿病肾病 肾脏血流动力学 

分 类 号：R587.2[医药卫生—内分泌]