基础胰岛素联合DPP4抑制剂或磺脲类药物在糖尿病肾病患者血糖控制中的疗效与安全性分析

Efficacy and Safety Analysis of Basal Insulin Combined with DPP4 Inhibitors or Sulfonylurea Drugs in Glycemic Control of Patients with Diabetic Nephropathy

目的探讨基础胰岛素联合DPP4抑制剂或磺脲类药物治疗糖尿病肾病的临床效果。方法选取该院2018年1月—2019年12月收治的2型糖尿病合并早期糖尿病肾病患者80例作为研究对象,在满足伦理学及患者知情权的基础上以1∶1的方法将对象分为实验组和对照组,每组40例;实验组以基础胰岛素联合利格列汀治疗,对照组采用基础胰岛素联合瑞格列奈治疗,比较两组的治疗效果。结果临床统计,实验组临床有效率97.50%(39/40),高于对照组85.00%(34/40),差异有统计学意义(χ^2=3.914,P<0.05);实验组治疗后的空腹血糖、餐后2 h血糖、糖化血红蛋白及尿素氮、血清肌酐、肾小球滤过率、尿蛋白排泄率各项指标均优于对照组,差异有统计学意义(P<0.05);两组低血糖事件发生率差异无统计学意义(P>0.05)。结论基础胰岛素联合利格列汀治疗糖尿病肾病的整体效果优于胰岛素联合瑞格列奈,建议优先应用。

Objective To explore the clinical effect of basal insulin combined with DPP4 inhibitors or sulfonylurea drugs on diabetic nephropathy.Methods A total of 80 patients with type 2 diabetes and early diabetic nephropathy admitted to our hospital from January 2018 to December 2019 were selected as the research objects.The objects were equally divided into two groups on the basis of satisfying ethics and patients'right to know.There were 40 cases in each group in the experimental group and the control group;the experimental group was treated with basal insulin combined with ritagliptin,and the control group was treated with basal insulin combined with repaglinide to compare the therapeutic effects of the two groups.Results According to clinical statistics,the clinical effective rate of the experimental group is 97.50%(39/40),which is higher than that of the control group 85.00%(34/40),the difference is statistically significant(χ^2=3.914,P<0.05);the fasting blood glucose after treatment,2 h blood glucose,glycated hemoglobin and urea nitrogen,serum creatinine,glomerular filtration rate,urine protein excretion rate are better than the control group,the difference is statistically significant(P<0.05);the incidence of hypoglycemia events in the two groups The difference was not statistically significant(P>0.05).Conclusion The overall effect of basal insulin combined with ritagliptin in the treatment of diabetic nephropathy is better than that of insulin combined with repaglinide.