利拉鲁肽联合贝那普利片治疗糖尿病肾病疗效及对血管内皮功能的影响

Effect of Liraglutide combined with Benazepril tablets on diabetic nephropathy and vascular endothelial function

目的结合临床实践经验,探讨利拉鲁肽联合贝那普利片治疗糖尿病肾病的疗效及对血管内皮功能的影响。方法选择2020年1月-2021年12月常德市德星医院收治的糖尿病肾病患者92例,按照随机数字表法随机分为联合组和贝那普利组,分别给予利拉鲁肽联合贝那普利片和单独应用贝那普利片治疗,比较两组患者临床疗效,并对治疗前后两组患者血管内皮功能、肾功能、肾动脉血流动力学参数指标进行比较,观察两组患者不良反应发生情况。结果联合组治疗总有效率(95.65%)明显高于贝那普利组(84.78%),差异有统计学意义(x^(2)=8.424,P=0.015)。治疗后联合组患者ET-1水平低于贝那普利组,NO水平高于贝那普利组(P<0.05)。治疗后联合组患者mALB、BUN和Scr水平均低于贝那普利组,差异有统计学意义(P<0.05)。治疗前两组患者肾动脉血流动力学参数指标比较,差异无统计学意义(P>0.05);治疗后联合组患者Vmax、Vmin水平均高于贝那普利组,RI低于贝那普利组,差异有统计学意义(P<0.05)。联合组患者并发症发生率(2.17%)明显低于贝那普利组(17.39%),差异有统计学意义(x^(2)=6.035,P=0.014)。结论利拉鲁肽联合贝那普利片治疗糖尿病肾病疗效显著,可改善患者血管内皮功能,提高患者肾功能,减轻不良反应,值得推广。

Objective Combined with clinical experience,to explore the efficacy of liraglutide combined with benazepril tablets in the treatment of diabetic nephropathy and the influence of vascular endothelial function.Methods Ninety-two patients with diabetic nephropathy admitted to our hospital from January 2020 to December 2021 were randomly divided into combination group and benazepril group according to random number table method,and were treated with liraglutide combined with benazepril tablet or benazepril tablet alone.The clinical efficacy of the two groups was compared.Vascular endothelial function,renal function and hemodynamic parameters of renal artery were compared between the two groups before and after treatment to observe the occurrence of adverse reactions in the two groups.Results The total effective rate of the combined group(95.65%)was significantly higher than that of the benazepril group(84.78%),and the difference was statistically significant(x^(2)=8.424,P=0.015).There was no significant difference in vascular endothelial function between the two groups before treatment(P>0.05).After treatment,the level of ET-1 in combination group was lower than that in benazepril group,and the level of NO was higher than that in Benazepril group,the difference was statistically significant(P<0.05).There was no significant difference in renal function indexes between the two groups before treatment(P>0.05).After treatment,the levels of mALB,BUN and Scr in combination group were lower than those in Benazepril group,with statistical significance(P<0.05).There was no significant difference in renal arterial hemodynamics parameters between the two groups before treatment(P>0.05).After treatment,the levels of Vmax and Vmin in combination group were higher than those in benazepril group,and RI was lower than that in Benazepril group,with statistical significance(P<0.05).The complication rate of combination group(2.17%)was significantly lower than that of Benazepril group(17.39%),the difference was statistically significant(x^(2)=6.035,P=0.014).Conclusion Liraglutide combined with benazepril tablets has significant curative effect in the treatment of diabetic nephropathy,which can improve the vascular endothelial function of patients,improve the kidney function of patients,reduce adverse reactions,and is worthy of further clinical promotion and application.