利拉鲁肽治疗糖尿病肾病的疗效分析

Analysis of therapeutic effect of liraglutide on diabetic nephropathy

目的探讨利拉鲁肽治疗糖尿病肾病的临床疗效。方法78例糖尿病肾病患者,随机分为对照组和研究组,每组39例。对照组采用常规对症治疗,研究组在对照组基础上应用利拉鲁肽皮下注射治疗。比较两组肾功能指标[尿白蛋白排泄率(UAER)、24 h尿蛋白定量(24 h Upro)、血肌酐(Scr)]、血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FIns)]、炎性因子指标[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、转化生长因子β1(TGF-β1)、内皮素]。结果治疗前,两组的UAER、24 h Upro、Scr水平比较差异均无统计学意义(P>0.05);治疗后,研究组的UAER、24 h Upro、Scr水平分别为(64.16±20.05)μg/min、(0.94±0.78)g/d、(76.58±11.84)μmol/L,均明显低于对照组的(79.23±22.25)μg/min、(1.67±1.01)g/d、(85.52±10.41)μmol/L,差异有统计学意义(P<0.05)。治疗前,两组的FPG、2 h PG、HbA1c、FIns水平比较差异均无统计学意义(P>0.05);治疗后,研究组的FPG、2 h PG、HbA1c、FIns水平分别为(5.38±1.01)mmol/L、(7.03±1.47)mmol/L、(6.43±0.81)%、(7.09±1.07)mIU/L,均明显低于对照组的(6.37±1.02)mmol/L、(8.58±1.94)mmol/L、(7.76±0.68)%、(8.66±1.46)mIU/L,差异有统计学意义(P<0.05)。治疗前,两组IL-6、TNF-α、TGF-β1、内皮素水平比较差异均无统计学意义(P>0.05);对照组治疗后的IL-6、TNF-α、TGF-β1、内皮素水平分别为(29.36±4.32)ng/L、(28.18±8.54)ng/L、(137.86±33.52)μg/L、(92.39±11.46)ng/L,研究组治疗后的IL-6、TNF-α、TGF-β1、内皮素水平分别为(23.78±2.96)ng/L、(19.62±4.03)ng/L、(113.08±31.06)μg/L、(72.48±9.57)ng/L;研究组治疗后的IL-6、TNF-α、TGF-β1、内皮素水平均明显低于对照组,差异有统计学意义(P<0.05)。结论糖尿病肾病患者采用利拉鲁肽治疗可有效改善其肾功能及血糖水平,且有助于促使炎性因子水平降低,值得推广。

Objective To discuss the clinical efficacy of liraglutide on diabetic nephropathy.Methods A total of 78 patients with diabetic nephropathy were randomly divided into control group and study group,with 39 cases in each group.The control group received conventional symptomatic treatment,and the study group received subcutaneous injection of liraglutide on the basis of the control group.Both groups were compared in terms of kidney function indexes[urinary albumin excretion rate(UAER),24 h urinary protein excretion(24 h Upro),serum creatinine(Scr)],blood glucose indexes[fasting plasma glucose(FPG),2 h postprandial glucose(2 h PG),glycosylated hemoglobin(HbA1c),fasting insulin(FIns),inflammatory factor indicators[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),transforming growth factor-β1(TGF-β1),endothelin].Results Before treatment,there were no statistically significant differences in UAER,24-h Upro and Scr levels between the two groups(P>0.05).After treatment,UAER,24-h Upro and Scr levels of the study group were(64.16±20.05)μg/min,(0.94±0.78)g/d and(76.58±11.84)μmol/L,which were significantly lower than those of(79.23±22.25)μg/min,(1.67±1.01)g/d and(85.52±10.41)μmol/L of the control group,and the differences were statistically significant(P<0.05).Before treatment,there were no statistically significant differences in FPG,2 h PG,HbA1c and FIns levels between the two groups(P>0.05).After treatment,FPG,2 h PG,HbA1c and FIns levels in the study group were(5.38±1.01)mmol/L,(7.03±1.47)mmol/L,(6.43±0.81)%and(7.09±1.07)mIU/L,which were significantly lower than those of(6.37±1.02)mmol/L,(8.58±1.94)mmol/L,(7.76±0.68)%and(8.66±1.46)mIU/L in the control group,and the differences were statistically significant(P<0.05).Before treatment,there were no statistically significant differences in IL-6,TNF-α,TGF-β1 and endothelin levels between the two groups(P>0.05).After treatment,the levels of IL-6,TNF-α,TGF-β1 and endothelin in the control group were(29.36±4.32)ng/L,(28.18±8.54)ng/L,(137.86±33.52)μg/L and(92.39±11.46)ng/L,respectively.After treatment,the levels of IL-6,TNF-α,TGF-β1 and endothelin in the study group were(23.78±2.96)ng/L,(19.62±4.03)ng/L,(113.08±31.06)μg/L and(72.48±9.57)ng/L,respectively;the levels of IL-6,TNF-α,TGF-β1 and endothelin in the study group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The treatment of liraglutide in diabetic nephropathy can effectively improve the kidney function and blood glucose level of patients,and help to reduce the level of inflammatory factors in patients,which is worthy of promotion.