利格列汀治疗肾脏移植术后新发糖尿病患者的临床效果及安全性

Clinical effect and safety of linagliptin for the treatment of new-onset diabetes mellitus in patients after renal transplantation

目的探讨利格列汀治疗肾脏移植术后新发糖尿病患者的临床效果及其安全性。方法回顾性分析30例接受口服利格列汀治疗的肾脏移植术后新发糖尿病患者的临床资料。比较患者治疗前后的空腹血糖水平、HbA1c水平、体质指数、24 h尿蛋白含量、血生化指标(血肌酐、总胆红素、ALT、AST)水平及血脂水平,并记录治疗过程中并发症的发生情况。结果与治疗前比较,患者治疗9个月后的空腹血糖水平降低,治疗6个月及9个月后患者的HbA1c水平降低(均P<0.05);患者治疗12个月后的体质指数、24 h尿蛋白含量及血肌酐、总胆红素、ALT、AST、总胆固醇、LDL水平差异无统计学意义(均P>0.05),而三酰甘油水平降低(P<0.05)。利格列汀治疗期间,共有4例患者出现并发症,并发症发生率为13.33%。结论利格列汀能够有效控制肾脏移植术后新发糖尿病患者的血糖水平,降低患者血脂水平,且安全性良好。临床上可将利格列汀作为治疗肾脏移植术后新发糖尿病患者的替选方案,尤其适用于三酰甘油水平升高的患者。

Objective To investigate the clinical effect and safety of linagliptin for treating new-onset diabetes mellitus in patients after renal transplantation.Methods The clinical data of 30 patients with new-onset diabetes mellitus after renal transplantation who received oral administration of linagliptin for treatment were retrospectively analyzed.The pre-and post-treatment fasting blood glucose level,HbA1c level,body mass index,24-hour urine protein content,and levels of blood biochemical indices(serum creatinine,total bilirubin,ALT,and AST),as well as blood lipid level were compared between patients;in addition,the occurrence of complications during treatment was recorded.Results Compared with before treatment,after 9 months of treatment,patients obtained a decline of fasting blood glucose level,and after 6 and 9 months of treatment,patients obtained a decline of HbA1c level(all P<0.05);moreover,after 12 months of treatment,the body mass index,and 24-hour urine protein content,and levels of serum creatinine,total bilirubin,ALT,AST,total cholesterol,LDL depicted no statistically significant difference in patients(all P>0.05),whereas patients′triglyceride level was decreased(P<0.05).During treatment with linagliptin,a total of 4 patients suffered from complications,with the incidence rate of complications of 13.33%.Conclusion Linagliptin can effectively control blood glucose level of patients with new-onset diabetes mellitus after renal transplantation,decrease patients′blood lipid level,and it exerts a favourable safety.Clinically linagliptin can be used as an alternative regimen for treating new-onset diabetes mellitus in patients after renal transplantation,especially for patients with elevated triglyceride level.