利格列汀在糖尿病肾病合并重度肾功能损害的临床研究

Clinical Study of Linagliptin in Diabetic Nephropathy Complicated with Severe Renal Function Impairment

目的探讨利格列汀在糖尿病肾病合并重度肾功能损害治疗中的效果。方法选取2020年4月—2022年4月湛江中心人民医院收治的80例糖尿病肾病合并重度肾功能损害患者为研究对象。所有患者均予以口服奥美沙坦、尿毒清常规治疗,按照随机数表法分为普通非透析组(A组)、利格列汀+非透析组(B组)、普通透析组(C组)、利格列汀+透析组(D组)4组,各20例,比较4组血糖指标、肾功能指标、不良心脑血管事件发生率、全因病死率。结果治疗后,B组的血糖达标率、20%肾小球滤过率的下降率等指标均优于A组,D组血糖达标率、20%肾小球滤过率的下降率等指标均优于C组,差异有统计学意义(P<0.05)。治疗后,B组血尿素氮、肌酐、白蛋白、血红蛋白、甲状旁腺素等指标均优于A组,D组血尿素氮、肌酐、白蛋白、血红蛋白、甲状旁腺素等指标均优于C组,差异有统计学意义(P<0.05)。A、B组淀粉酶水平比较,C、D组淀粉酶水平比较,差异无统计学意义(P>0.05)。B组不良心脑血管事件发生率明显低于A组,D组不良心脑血管事件发生率明显低于C组,差异有统计学意义(P<0.05)。4组全因病死率比较,差异无统计学意义(P>0.05)。结论对于糖尿病肾病合并重度肾功能损害患者,在常规治疗的基础上加用利格列汀可有效改善患者血糖水平及肾功能,且有助于预防不良心脑血管事件。

Objective To investigate the effect of rigliptin in the treatment of diabetic nephropathy complicated with severe renal function impairment.Methods A total of 80 diabetic nephropathy patients with severe renal function im-pairment admitted to Zhanjiang Central People's Hospital from April 2020 to April 2022 were selected as the study objects.All patients were treated with oral olmesartan and routine uric acid therapy,and were divided into 4 groups according to random number table method:general non-dialysis group(Group A),ligagliptin+non-dialysis group(Group B),general dialysis group(Group C),and ligagliptin+dialysis group(Group D),with 20 cases each.Blood glu-cose index,renal function index,incidence of unconscionable cerebrovascular events and all-cause mortality were compared in the 4 groups.Results After treatment,the blood glucose compliance rate and the decrease rate of 20%glomerular filtration rate in Group B were better than those in Group A,while the blood glucose compliance rate and the decrease rate of 20%glomerular filtration rate in Group D were better than those in Group C,and the differences were statistically significant(P<0.05).After treatment,the blood urea nitrogen,creatinine,albumin,hemoglobin,para-thyroid hormone and other indicators in Group B were better than those in Group A,while the blood urea nitrogen,cre-atinine,albumin,hemoglobin,parathyroid hormone and other indicators in Group D were better than those in Group C,and the differences were statistically significant(P<0.05).The comparison of amylase levels between Group A and Group B,as well as the comparison of amylase levels between Group C and Group D,and the differences were not sta-tistically significant(P>0.05).The incidence of adverse cardiovascular and cerebrovascular events in Group B was sig-nificantly lower than that in Group A,and the incidence of adverse cardiovascular and cerebrovascular events in Group D was significantly lower than that in Group C,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the all-cause mortality rates among the four groups(P>0.05).Conclusion For patients with diabetic nephropathy complicated with severe renal function impairment,the addition of rigagliptin on the basis of conventional treatment can effectively improve the blood glucose level and renal function,and help to prevent unconscionable cerebrovascular events.