肾移植术后糖尿病药物治疗研究进展

Research Progress of Drug Therapy for Diabetes Mellitus after Kidney Transplantation

肾移植术后糖尿病严重影响患者生活质量和生存预后。目前的新型降糖药物主要包括胰高血糖素样肽-1受体激动剂(GLP-1RA)、钠-葡萄糖协同转运蛋白-2(SGLT2)抑制剂和二肽基肽酶-4(DPP-4)抑制剂等。GLP-1RA和DPP-4抑制剂在肾移植术后糖尿病患者中的疗效较好,同时其轻度胃肠道不良反应也并不会影响移植后患者的免疫抑制水平。SGLT2抑制剂在肾移植术后糖尿病患者中的降糖功效较差且可引发尿路感染,从而影响移植物功能。新型降糖药物在肾移植术后糖尿病的治疗中具有潜在价值,未来进一步探索其疗效及安全性,可以为疾病的治疗提供新思路。

Diabetes mellitus after kidney transplantation seriously affects the quality of life and survival prognosis.Existing new hypoglycemic drugs mainly include glucagon-like peptide-1 receptor agonist(GLP-1RA),sodium-glucose co-transporter 2(SGLT2)inhibitor and dipeptidyl peptidase-4(DDP4)inhibitor etc.GLP-1RA and DDP4 inhibitors have good efficacy in diabetic patients after kidney transplantation,and their mild gastrointestinal adverse effects do not affect the immunosuppression level of the patients after transplantation.SGLT2 inhibitors have poor hypoglycemic efficacy in diabetic patients after kidney transplantation,and can cause urinary tract infections,which affect the graft function.The new hypoglycemic drugs have potential value in the treatment of diabetes after kidney transplantation,and their efficacy and safety can be further explored in the future,which can provide new ideas for the treatment.