维格列汀联合二甲双胍治疗中老年2型糖尿病(T2DM)合并中度肾损伤患者临床研究

Clinical Study of Vildagliptin Combined with Metformin in the Treatment of Middle-aged and Elderly Patients with Type 2 Diabetes Mellitus(T2DM)Complicated with Moderate Renal Injury

目的研究二甲双胍联合维格列汀对中老年2型糖尿病(type 2 diabetes mellitus,T2DM)合并中度肾损伤患者的影响。方法选取2018年11月—2021年11月厦门市第五医院收治的中老年T2DM合并中度肾损伤患者52例为研究对象,按入院顺序分为对照组和观察组,各26例。对照组采用二甲双胍治疗,观察组在对照组基础上采用维格列汀治疗。比较两组治疗前后糖代谢指标、脂代谢指标、肾功能相关指标、病情相关因子及不良反应发生率。结果治疗后,观察组糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2h血糖(2hPG)水平较对照组低,差异有统计学意义(P<0.05);治疗后,观察组血清低密度脂蛋白(LDL-C)、三酰甘油(TG)、总胆固醇(TC)水平低于对照组,高密度脂蛋白(HDL-C)水平高于对照组,差异有统计学意义(P<0.05);治疗后,观察组肌酐(Scr)、胱抑素C(CysC)、尿素氮(BUN)水平较对照组低,肾小球滤过率(GFR)较对照组高,差异有统计学意义(P<0.05);治疗后,观察组血清生长分化因子-15(GDF-15)低于对照组,分泌型卷曲蛋白5(SFRP-5)、网膜素-1(omentin-1)高于对照组,差异有统计学意义(P<0.05);观察组不良反应总发生率(11.54%)与对照组(7.69%)比较,差异无统计学意义(P>0.05)。结论二甲双胍联合维格列汀治疗T2DM合并肾损伤,安全可靠,能调节患者糖脂代谢,减轻氧化应激反应,促进疾病转归。

Objective To study the effect of vildagliptin combined with metformin in the treatment of middle-aged and elderly patients with type 2 diabetes mellitus(T2DM)complicated with moderate renal injury.Methods 52 middle-aged and elderly patients with T2DM combined with moderate renal injury admitted to the Fifth Hospital of Xiamen from November 2018 to November 2021 were selected for the study,and they were divided into a control group and an observation group according to the order of admission,with 26 cases in each group.The control group was treated with metformin,and the observation group was treated with vildagliptin on this basis.The incidence of glucose metabolism index,lipid metabolism index,renal function-related index,condition-related factors and adverse reactions were compared between the two groups before and after treatment.Results After treatment,glycosylated hemoglobin(HbA1c),fasting glucose(FPG)and 2 h postprandial glucose(2 hPG)levels in the observation group were lower than control group,the difference was statistically significant(P<0.05);after treatment,serum low-density lipoprotein(LDL-C),triacylglycerol(TG)and total cholesterol(TC)levels in the observation group were lower than in the control group,and high-density lipoprotein(HDL-C)levels were higher than the control group,the difference was statistically significant(P<0.05);creatinine(Scr),cystatin C(CysC),and urea nitrogen(BUN)levels in the observation group were lower than the control group and glomerular filtration rate(GFR)was higher than the control group after treatment,the difference was statistically significant(P<0.05);serum growth differentiation factor-15(GDF-15)was lower than the control group,secretory frizzled protein 5(SFRP-5),and omentin-1(omentin-1)were higher than those in the control group,the difference was statistically significant(P<0.05);the overall incidence of adverse reactions in the observation group(11.54%)was compared with that in the control group(7.69%),the difference was not statistically significant(P>0.05).Conclusion Vildagliptin combined with metformin for the treatment of T2DM combined with renal injury is safe and reliable,can regulate patients’glucolipid metabolism,reduce oxidative stress and promote disease regression.