利拉鲁肽对糖尿病肾病患者可溶性肿瘤坏死因子受体的影响

Effects of liraglutide on soluble tumor necrosis factor receptor in patients with diabetic nephropathy

目的:探究利拉鲁肽对糖尿病肾病患者可溶性肿瘤坏死因子受体的影响。方法:选择本院2016年12月~2017年12月收治的早期糖尿病肾病患者110例,根据随机数字表法将所有患者分为两组,每组各55例。对照组患者给予降糖等常规对症治疗,观察组患者在常规对症治疗的基础上给予利拉鲁肽治疗。比较两组肾功能、血糖代谢水平、血清指标、血管内皮功能及药物不良反应。结果:治疗后,两组患者24h尿蛋白定量(24hUpor)、尿清蛋白排泄率(UAER)、血肌酐(Scr)水平低于治疗前,且观察组24hUpor、UAER、Scr水平低于对照组,差异具有统计学意义(P<0.05)。治疗后,两组餐后2h血糖(PBG)、空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)及空腹胰岛素(FIns)水平较治疗前显著下降,且观察组PBG、FPG、HOMA-IR、HbA1c及FIns水平低于对照组,差异具有统计学意义(P<0.05)。治疗后,两组患者肿瘤坏死因子(TNF-α)、肿瘤坏死因子受体1(sTNFR1)、hs-CRP水平较治疗前明显下降,且观察组TNF-α、sTNFR1、hs-CRP水平明显低于对照组,差异具有统计学意义(P<0.05)。治疗后,两组患者一氧化氮(NO)水平较治疗前明显提高、内皮素-1(ET-1)水平较治疗前明显降低,且观察组患者NO水平高于对照组、ET-1水平低于对照组,差异具有统计学意义(P<0.05)。结论:利拉鲁肽可有效改善糖尿病肾病患者肾功能及血糖水平,提高胰岛素敏感性,降低炎性因子水平,改善血管内皮功能,安全性较高。

Objective：To observe the effects of Liraglutide combined with sequential dialysis on soluble tumor necrosis factor receptor in patients with diabetic nephropathy.Methods：110 patients with early diabetic nephropathy who had been seeking treatment in the hospital between December 2016 and December 2017 were selected and according to the random number table method,these patients were randomly divided into two groups,with 55 cases in each group.Patients in the control group were given conventional symptomatic treatment such as hypoglycemic therapy,whereas the observation group was treated with Liraglutide based on the conventional symptomatic treatment given to the control group.The renal function,blood glucose metabolism level,serum indexes,vascular endothelial function and adverse drug reactions were compared between the two groups.Results：After treatment,the levels of 24 hUpor,UAER and Scr in the two groups were both shown to be lower than those before treatment,and the levels in the observation group were shown to be lower than those in the control group,with the differences being statistically significant（P〈0.05）.After treatment,the levels of PBG,FPG,HOMA-IR,HbA1c and FIns in the two groups were both significantly lower than before treatment,and the levels of PBG,FPG,HOMA-IR,HbA1c and FIns in the observation group were shown to be lower than those in the control group,where the differences were statistically significant（P〈0.05）.After treatment,the levels of TNF-α,sTNFR1 and hs-CRP in the two groups were significantly reduced than before treatment,and the levels in the observation group were shown to be significantly lower than the control group,with statistically significant differences（P〈0.05）.After treatment,the NO levels in both groups were significantly increased and ET-1 level significantly reduced than before treatment,and the NO level in the observation group was shown to be higher and the ET-1 level lower than the control group,where the difference was statistically significant（P〈0.05）.Conclusion：Liraglutide can effectively improve their renal function and blood glucose of the patients with diabetic nephropathy,enhance insulin sensitivity,reduce the levels of inflammatory factors,improve the endothelial function and safety.