胰高糖素样肽1受体激动剂与钠-葡萄糖共转运蛋白2抑制剂治疗2型糖尿病伴肾损害结局比较的Meta分析  

Efficacy and clinical outcomes of GLP-1 receptor agonists and SGLT-2 inhibitors in diabetics with renal impairment:a Meta-analysis

作　　者：刘晶[1] 范芳芳[1] 张彦[1] 赵生俊[1] Liu Jing;Fan Fang-fang;Zhang Yan;Zhao Sheng-jun(Department of Pharmacy,Affiliated Hospital of Traditional Chinese Medicine,Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学附属中医医院药学部,乌鲁木齐830000

出　　处：《临床肾脏病杂志》2023年第3期228-233,共6页Journal Of Clinical Nephrology

摘　　要：目的评价胰高糖素样肽1(glucagon-like peptide-1,GLP-1)受体激动剂与钠-葡萄糖共转运蛋白2(sodium-glucose cotransporter protein-2,SGLT-2)抑制剂治疗2型糖尿病伴肾损害的疗效。方法以“diabetes mellitus complicated with kidney injury”“GLP-1 receptor agonist”“SGLT-2 inhibitor”“Randomized control”“糖尿病合并肾损伤”“GLP-1受体激动剂”“SGLT-2抑制剂”“随机对照”等为关键词对中国知网、维普、万方、Web of Science、PubMed、Embase等数据库进行检索分析,检索时限从建库到2022年1月间公开发表的随机对照试验,采用RevMan 5.3软件进行Meta分析。结果共检索到2146篇GLP-1受体激动剂与SGLT-2抑制剂的疗效和临床结局的文章,经筛选最终8篇纳入本次研究。与对照相比,GLP-1受体激动剂、SGLT-2抑制剂在降低糖化血红蛋白方面更具有优势(MD=-0.36,95%CI:-0.52~-0.19,P<0.05);GLP-1受体激动剂与SGLT-2抑制剂能够更好地提升估算肾小球滤过率水平(MD=0.28,95%CI:0.08~0.48,P=0.005);GLP-1受体激动剂与SGLT-2抑制剂均能够更好地降低患者尿白蛋白/肌酐比值(MD=-1.37,95%CI:-1.55~-1.20,P<0.05);GLP-1受体激动剂与SGLT-2抑制剂在治疗不同肾损害程度时,不良反应的差异无统计学意义(P>0.05)。结论GLP-1受体激动剂与SGLT-2抑制剂在治疗糖尿病合并肾损害中均具有一定价值。Objective To evaluate the efficacy of GLP-1 receptor agonists and SGLT-2 inhibitors in the treatment of type 2 diabetes mellitus with renal damage.Methods Based on the keywords of“diabetes mellitus plus kidney injury”,“GLP-1 receptor agonist”and“SGLT-2 inhibitor”,the databases of China National Knowledge Infrastructure(CNKI),VIP,WanFang,Web of Science,PubMed and Embase were searched for randomized controlled trials(RCTs).The retrieval time was from the establishment of the database to January 2022.Meta-analysis was performed by RevMan5.3 software.Results A total of 2146 articles on the efficacy and clinical outcomes of GLP-1 receptor agonists and SGLT-2 inhibitors were retrieved.After screening,8 articles were finally included.Compared with controls,GLP-1 receptor agonists and SGLT-2 inhibitors offered more advantages in lowering HbA1c(MD=-0.36,95%CI:-0.52~-0.19,P<0.05);GLP-1 receptor agonists and SGLT-2 inhibitors could better reduce the level of eGFR(MD=0.28,95%CI:0.08~0.48,P=0.005);Both GLP-1 receptor agonists and SGLT-2 inhibitors could better reduce UACR(MD=-1.37,95%CI:-1.55~-1.20,P<0.05).No significant difference existed in adverse reactions between GLP-1 receptor agonist and SGLT-2 inhibitor for varying degrees of renal damage(P>0.05).Conclusion GLP-1 receptor agonists and SGLT-2 inhibitors have some values in the treatment of diabetics with renal damage.

关 键 词：糖尿病合并肾损伤 GLP-1受体激动剂 SGLT-2抑制剂 META分析 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]