达格列净联合利拉鲁肽治疗糖尿病肾病患者的效果及对UAER、BUN及CⅣ水平的影响

Effect of dapagliflozin combined with liraglutide in the treatment of patients with diabetic kidney disease and its influence on UAER, BUN and CIV levels

目的 探讨达格列净联合利拉鲁肽治疗糖尿病肾病(DKD)的临床效果。方法 纳入2020年1月至2021年12月收治的86例DKD患者为研究对象,以随机数字表法将其分为A组(n=43)和B组(n=43)。A组给予利拉鲁肽注射液治疗,B组在A组基础上联合应用达格列净治疗。比较两组的治疗效果。结果 B组的治疗总有效率显著高于A组(P<0.05);两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。治疗后,两组的尿白蛋白排泄率(UAER)、尿白蛋白(UAlb)、血尿素氮(BUN)水平均明显降低,且B组低于A组(P<0.05)。治疗后,两组的Ⅳ型胶原(CⅣ)、胱抑素C(Cys C)、基质金属蛋白酶组织抑制剂-1(TIMP-1)水平均明显降低,且B组低于A组(P<0.05)。治疗后,B组的空腹血糖(FPG)、空腹胰岛素(FINS)水平及胰岛素抵抗指数(HOMA-IR)均低于A组(P<0.05)。结论 达格列净联合利拉鲁肽治疗DKD效果显著,可促进患者肝肾功能改善。

Objective To explore the clinical effect of dapagliflozin combined with liraglutide in the treatment of diabetic kidney disease(DKD).Methods A total of 86 patients with DKD admitted from January 2020 to December 2021 were included as the research objects.The patients were divided into group A(n=43)and group B(n=43)by random number table method.The group A was treated with liraglutide injection,and the group B was treated with dapagliflozin on the basis of the group A.The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the group B was significantly higher than that in the group A(P<0.05);there was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).After treatment,the levels of urinary albumin excretion rates(UAER),urinary albumin(UAlb)and blood urea nitrogen(BUN)in the two groups significantly decreased,and those in the group B were lower than the group A(P<0.05).After treatment,the levels of collage typeⅣ(CⅣ),cystatin C(Cys C)and tissue inhibitor of metalloproteinases-1(TIMP-1)in the two groups significantly decreased,and those in the group B were lower than the group A(P<0.05).After treatment,the fasting plasma glucose(FPG),fasting insulin(FINS)levels and homeostasis model assessment for insulin resistance index(HOMA-IR)in the group B were lower than those in the group A(P<0.05).Conclusion Dapagliflozin combined with liraglutide is effective in the treatment of DKD,which can promote the improvement of liver and kidney function.