GLP-1受体激动剂利拉鲁肽在糖尿病肾病治疗中的疗效观察

Curative effect of GLP-1 receptor agonist liraglutide in the treatment of diabetic kidney disease

目的探讨GLP-1受体激动剂利拉鲁肽在糖尿病肾病患者临床治疗中的疗效。方法选取2018年9月-2019年12月在我院肾内科确诊的糖尿病肾病患者116例,随机分为对照组和观察组,每组58例。其中观察组男32例,女26例;对照组男30例,女28例。两组患者的年龄、体重比较差异无统计学意义。对照组给予常规血糖、血脂、血压控制等治疗,观察组在对照组治疗基础上给予皮下注射利拉鲁肽,1次/d,治疗周期为10周。比较两组患者肾功能各项指标及炎症细胞因子(TNF-α、IL-6、TGF-β1、内皮素)的变化情况。结果治疗后,观察组患者的体重、餐后血糖、尿总蛋白水平显著低于对照组(P<0.05)。炎症细胞因子(TNF-α、IL-6、TGF-β1)水平显著低于对照组(P<0.05),且观察组炎症细胞因子水平与体重降低相关。结论GLP-1受体激动剂利拉鲁肽通过降低炎症细胞因子水平对肾小球内皮的损害,可改善肾小球滤过膜通透性,减少蛋白渗出,对糖尿病肾病患者肾功能有一定的保护作用。

Objective To investigate the mechanism of GLP-1 receptor agonist liraglutide in the treatment of diabetic kidney disease.Methods Totally 116 patients with diabetic kidney disease diagnosed in our hospital from September 2018 to December 2019 were randomly divided into two groups(control group and observation group),58 cases in each group.There were 32 males and 26 females in the observation group and 30 males and 28 females in the control group.There was no statistical difference in age or weight between the two groups.The control group was given routine control of blood sugar,blood lipids and blood pressure and other treatments.In addition to routine treatment,the observation group was injected subcutaneously with liraglutide once a day.The treatment period was 10 weeks.The renal function indexes and the changes of inflammatory cytokines(TNF-α,IL-6,TGF-β1 and endothelin)were compared.Results After 10 weeks of liraglutide treatment,the weight,postprandial blood glucose and urine total protein levels in the observation group were significantly lower than those in the control group(P<0.05).The TNF-α,IL-6 and TGF-β1 in the observation group was significantly lower than that in the control group(P<0.05),and the level of Inflammatory cytokine in the observation group was positively correlated to the weight loss.Conclusion Liraglutide can reduce the damage to glomerular endothelium by reducing the level of inflammatory cytokines,improve the permeability of glomerular filtration membrane,reduce protein exudation,and protect the renal function in the patients with diabetic kidney disease.