利拉鲁肽和达格列净治疗糖尿病肾病的疗效比较

Comparison of Therapeutic Effects of Liraglutide and Dagliflozin in the Treatment of Diabetes Nephropathy

目的评估利拉鲁肽和达格列净治疗糖尿病肾病的疗效。方法将180例DN患者,随机分为对照组、利拉鲁肽组和达格列净组,每组60例。疗程均为3月,比较治疗前后各组患者体重指数、血红蛋白A1c(HbA1c)、血清肌酐(sCr)、尿酸(UA)、尿微量白蛋白(uMA)、尿肌酐(uCr)和双侧肾功能,并观察各组的不良反应,同时测定各组患者治疗前后血清白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平。结果治疗后:利拉鲁肽和达格列净组的体重指数、HbA1c、sCr、UA和uMA/uCr比值均低于对照组(所有P<0.05);各组患者血清白蛋白(sAlb)水平均升高,且实验组明显高于对照组(所有P<0.05);各组患者估计肾小球滤过率(eGFR)水平均升高,实验组高于对照组,但无统计学差异;除对照组体重指数外,3组其他各项代谢指标均有明显改善(所有P<0.05);各组患者血清IL-6和TNF-α水平均较低,实验组明显低于对照组(所有P<0.05)。治疗期间,各组患者均未观察到严重不良反应。结论两种药物均可以治疗糖尿病肾病,且疗效无统计学差异。

Objective To evaluate the efficacy of liraglutide and dagliflozin in the treatment of diabetes nephropathy(DN).Methods 180 DN patients were randomly divided into control group,liraglutide group,and dagliflozin group,with 60 patients in each group.Body mass index(BMI),hemoglobin A1c(HbA1c),serum creatinine(sCr),uric acid(UA),urine microalbumin(uMA),urine creatinine(uCr),and bilateral kidney function were compared before and after treatment,and adverse reactions in all groups were observed.Serum interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels were also evaluated.Results After treatment,the BMI,HbA1c,sCr,UA,and uMA/uCr ratios of the experimental group were lower than those of the control group(all P<0.05).Serum albumin(sAlb)levels were increased in all groups,and the experimental group showed a significant difference compared with the control group(all P<0.05).Estimated glomerular filtration rate(eGFR)levels were increased in all groups,and the experimental group was higher than the control group,with no significant differences;Except for the BMI of control group,all other metabolic indicators in the three groups showed significant improvement(all P<0.05);After treatment,Serum IL-6 and TNF-αlevels in all groups were lower,and the experimental group was significantly lower than the control group(all P<0.05).No serious adverse reactions were observed in all groups.Conclusion Both drugs could treat patients with DN,but there is no statistical difference between the two groups.