利拉鲁肽对早期2型糖尿病肾病患者尿白蛋白/肌酐比值及血肌酐变化的影响

Effect of liraglutide on urinary albumin / creatinine ratio and serum creatinine in patients with early type 2 diabetic nephropathy

目的探讨利拉鲁肽对早期2型糖尿病肾病患者尿白蛋白/肌酐比值(ACR)及血肌酐(SCr)变化的影响。方法选取2021年1月至2022年4月南昌市第一医院收治的86例早期2型糖尿病肾病患者作为研究对象,采用随机数表法分为对照组与研究组,每组43例。对照组给予胰岛素治疗,研究组给予胰岛素联合利拉鲁肽治疗。比较两组血糖、肾功能、血脂、炎症因子指标、不良反应发生情况及健康状况评分。结果治疗后,研究组腹胰岛素(FINS)、糖化血红蛋白A1c(HbA1c)、空腹血糖(FPG)及餐后2 h血糖(2 h PBG)水平均低于对照组,差异有统计学意义(P<0.05)。治疗后,研究组尿ACR、SCr、24 h尿微量白蛋白水平均低于对照组,差异有统计学意义(P<0.05)。治疗后,研究组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平均低于对照组,差异有统计学意义(P<0.05)。治疗后,研究组超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)水平均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。治疗后,研究组生理机能、生理职能、情感职能、精神健康、生命活力、社会功能、躯体疼痛及总体健康评分均高于对照组,差异有统计学意义(P<0.05)。结论利拉鲁肽治疗可有效降低尿ACR及SCr水平,降低血脂、血糖、炎症因子水平,改善患者肾功能,改善健康状况,且不明显增加不良反应。

Objective To explore the effect of liraglutide on urinary albumin/creatinine ratio(ACR)and serum creatinine(SCr)in patients with early type 2 diabetic nephropathy.Methods 86 patients with early type 2 diabetic nephropathy admitted to Nanchang First Hospital from January 2021 to April 2022 were selected as the research subjects,they were divided into the control group and the study group by the random number table method,with 43 cases in each group.The control group was treated with insulin,and the study group was treated with insulin combined with liraglutide.The blood glucose,renal function,blood lipids,inflammatory factors,adverse reactions and health status scores were compared between the two groups.Results After treatment,the levels of fasting insulin(FINS),glycosylated hemoglobin A1c(HbA1c),fasting plasma glucose(FPG)and postprandial 2 h blood glucose(2 h PBG)in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).After treatment,the urinary ACR,SCr,and 24 h urinary microalbumin levels in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of total cholesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups.After treatment,the scores of physiological function,physiological function,emotional function,mental health,vitality,social function,physical pain and overall health in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Liraglutide treatment can effectively reduce urinary ACR and SCr levels,reduce blood lipid,blood glucose,inflammatory factor levels,improve renal function and health status of patients,and does not significantly increase adverse reactions.