司美格鲁肽对2型糖尿病伴慢性心力衰竭合并肾功能不全患者的疗效与安全性观察研究

Efficacy and safety of Semaglutide in the treatment of type 2 diabetes mellitus patients with chronic heart failure and renal insufficiency

目的 探索司美格鲁肽对2型糖尿病伴慢性心力衰竭(CHF)合并肾功能不全患者的临床效果及安全性。方法 选取2022年1月-2022年9月于新疆医科大学第一附属医院就诊的71例2型糖尿病合并CHF及肾功能不全的患者作为研究对象,根据治疗方案随机分为对照组(胰岛素治疗,35例)与治疗组(胰岛素联合司美格鲁肽治疗,36例)。比较2组治疗的临床疗效与安全性。结果 治疗3个月后,治疗组HbA1c达标有效率为72.2%,显著高于对照组的有效率(31.4%)(P <0.05)。治疗后治疗组的体质量、FBG、HbA1c和TG均出现明显下降并显著低于对照组(P <0.05)。与对照组比较,联合应用司美格鲁肽治疗后出现LVEF升高、BNP降低、UACR和尿α1MG下降,差异具有显著统计学意义(P <0.05)。但2组的不良反应无明显区别(P> 0.05)。结论 司美格鲁肽对2型糖尿病伴CHF合并肾功能不全患者具有良好的血糖控制效果,可显著改善心功能,减少肾脏病病情进展,临床应用安全性较高。

Objective To explore the clinical eficacy and safety of Semaglutide in type 2 diabetes mellitus(T2DM)patients with chronic heart failure(CHF)and renal insuficiency.Methods 71 patients with T2DM complicated with CHF and renal insufficiency admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2022 to September 2022 were selected.According to the treatment scheme,the patients enrolled were randomly divided into the control group(insulin treatment,35 patients)and the treatment group(insulin combined with Semaglutide for treatment,36 patients).The clinical eficacy and safety of treatment were compared between two groups.Results After 3 months of treatment,the effective rate of HbAlc reaching the therapy standard in the treatment group(72.2%)was significantly higher than that in the control group(31.4%)(P<0.05).After treatment,the body mass,and the levels of fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c)and triglyceride(TG)in the treatment group showed the significant decrease and were significantly lower than those in the control group(P<0.05).Compared with the control group,the combined use of Semaglutide treatment in the treatment group resulted in the increase in left ventricular ejection fractions(LVEF),and the decrease in brain natriuretic peptide(BNP)level,urinary albumin creatinine ratio(UACR)and urineαl-microglobulin(alMG)level,and there were statistically significant differences in these indicators between two groups(P<0.05).However,there was no significant difference in the adverse reactions between two groups(P>0.05).Conclusion Semaglutide has a good blood glucose control effect on T2DM patients with CHF and renal insufficiency,can significantly improve cardiac function,reduce the progression of kidney disease,and has high clinical safety.