利拉鲁肽联合二甲双胍与缬沙坦治疗合并骨质疏松的糖尿病肾病患者的疗效  

The ourative effect of liraglutide combined with metformin and valsartan in the treatment of diabetes nephropathy patients with osteoporosis

作　　者：张丽莎 程玲 阴苗苗 张楠 张静[1] 王海芳[1] ZHANG Li-sha;CHENG Ling;YIN Miao-miao;ZHANG Nan;ZHANG Jing;WANG Hai-fang(Department of Endocrinology I,Handan First Hospital,Handan 056000,Hebei,China;Department of Clinical Laboratory,Handan First Hospital,Handan 056000,Hebei,China)

机构地区：[1]邯郸市第一医院内分泌一科,河北邯郸056000 [2]邯郸市第一医院检验科,河北邯郸056000

出　　处：《川北医学院学报》2024年第3期363-366,共4页Journal of North Sichuan Medical College

基　　金：河北省邯郸市科技局项目(22422083046ZC)。

摘　　要：目的:探讨利拉鲁肽联合二甲双胍与缬沙坦治疗合并骨质疏松的糖尿病肾病患者的临床疗效。方法:选取204例糖尿病肾病合并骨质疏松的患者为研究对象,按照治疗方式不同分为对照组(n=102)及观察组(n=102)。对照组采取二甲双胍联合缬沙坦治疗;观察组在对照组的基础上联合腹部注射利拉鲁肽注射液治疗。连续治疗12周后,比较两组患者血糖水平、肾功能、骨代谢及内皮功能。结果:治疗后,两组患者空腹血糖(FBG)、糖化血红蛋白(HbA1C)及餐后2 h血糖(2 h-PBG)等血糖指标,患者尿酸(UA)、血尿素氮(BUN)等肾功能指标,总Ⅰ型前胶原氨基端延长肽(t-PINP)、β-胶原特殊序列(β-CTx)等骨代谢指标水平、内皮功能指标内皮素-1(ET-1)均下降,且观察组低于对照组(P<0.05);其中骨代谢指标骨钙素N端中分子片段(N-MID)水平、内皮功能指标一氧化氮(NO)高于治疗前,且观察组高于对照组(P<0.05)。结论:利拉鲁肽联合二甲双胍与缬沙坦治疗合并骨质疏松的糖尿病肾病患者疗效确切,有利于降低患者血糖水平,促进骨生成、抑制骨吸收,改善肾功能及血管内皮功能。Objective:To investigate the clinical efficacy of liraglutide combined with metformin and valsartan in the treatment of diabetes nephropathy patients with osteoporosis.Methods:A total of 204 patients with diabetic nephropathy complicated with osteoporosis were divided into control group(n=102)and observation group(n=102)according to different treatment methods.The control group was treated with metformin combined with valsartan,while the observation group was treated with abdominal injection of liraglutide injection on the basis of the control group.After 12 weeks of continuous treatment,the blood glucose level,renal function,bone metabolism and endothelial function were compared between the two groups.Results:The blood glucose indexes such as fasting blood glucose(FBG),glycosylated hemoglobin(HbA1C)and postprandial 2 h blood glucose(PBG),renal function indexes such as uric acid(UA)and blood urea nitrogen(BUN),bone metabolism indexes such as total type I procollagen amino terminal extension peptide(t-PINP)andβ-collagen special sequence(β-CTx),and endothelial function index endothelin-1(ET-1)were lower than those before treatment,and the observation group was lower than the control group(P<0.05).Among them,the level of bone metabolism index osteocalcin N-terminal middle molecular fragment(N-MID)and endothelial function index nitric oxide(NO)were higher than those before treatment,and the observation group was higher than the control group(P<0.05).Conclusion:Liraglutide combined with metformin and valsartan is effective in the treatment of diabetes nephropathy patients with osteoporosis,which is conducive to reducing the blood sugar level of patients,promoting bone formation,inhibiting bone absorption,and improving renal function and vascular endothelial function.

关 键 词：利拉鲁肽 二甲双胍 缬沙坦 骨质疏松 糖尿病肾病 

分 类 号：R587.1[医药卫生—内分泌] R322.71[医药卫生—内科学]