摘要
目的分析糖尿病肾病患者单独使用胰高血糖素样肽-1(GLP-1)受体激动剂利拉鲁肽以及联合钠-葡萄糖协同转运蛋白2抑制剂恩格列净治疗的效果,以及对心肾功能,血管内皮生长因子(VEGF)、VEGF-A水平的影响。方法选择该院2022年4月至2023年5月收治的84例糖尿病肾病患者纳入研究对象,分为对照组和试验组,各42例。对照组患者单独使用GLP-1受体激动剂利拉鲁肽治疗,试验组使用GLP-1受体激动剂利拉鲁肽与恩格列净治疗,分析、比较两种不同方案对患者疗效的影响。结果治疗前,两组糖化血红蛋白(HbA1c)、餐后2 h血糖(2 h PG)、空腹血糖(FBG)、左室射血分数(LVEF)、左室后壁厚度(LVPWT)、左室舒张末期内径(LVEDD)、左室舒张早期充盈峰/舒张末期充盈峰(E/A)、尿微量清蛋白/尿肌酐(ACR)、血肌酐(Scr)、尿肌酐(Ucr)、胰岛素用量比较,差异均无统计学意义(P>0.05),治疗后,与对照组比较,试验组HbA1c、2 h PG、FBG、LVPWT、LVEDD、ACR、Scr、Ucr水平更低,胰岛素用量更少,E/A、LVEF更高,差异均有统计学意义(P<0.05)。治疗前,两组患者VEGF、VEGF-A比较,差异均无统计学意义(P>0.05),治疗后,试验组VEGF、VEGF-A水平低于对照组(P<0.05)。试验组与对照组患者的低血糖、腹泻、低血压等不良反应总发生率比较,差异无统计学意义(P>0.05)。结论糖尿病肾病患者使用GLP-1受体激动剂利拉鲁肽联合恩格列净治疗的降糖效果较好且安全,还可以改善心肾功能,抑制VEGF、VEGF-A的过度表达,并减少胰岛素用量。
Objective To analyze the effects of glucagon-like peptide-1(GLP-1)receptor agonist liraglutide alone and in combination with the sodium-glucose co-transporter 2(SGLT-2)inhibitor empagliflozin in the treatment of patients with diabetic nephropathy,and to evaluate their impact on cardiac and renal function,as well as levels of vascular endothelial growth factor(VEGF)and VEGF-A.Methods A total of 84 patients with diabetic nephropathy treated at the hospital from April 2022 to May 2023 were selected as the study subjects and divided into two groups,with 42 patients in each group.The control group received treatment with the GLP-1 receptor agonist liraglutide alone,while the experimental group was treated with both the GLP-1 receptor agonist liraglutide and empagliflozin.The therapeutic effects of the two different treatment regimens were analyzed and compared.Results Before treatment,there was no statistically significant difference between the two groups in terms of glycated hemoglobin(HbA1c),postprandial 2-hour blood glucose(2 h PG),fasting blood glucose(FBG),left ventricular ejection fraction(LVEF),left ventricular posterior wall thickness(LVPWT),left ventricular end-diastolic diameter(LVEDD),early diastolic filling peak/late diastolic filling peak(E/A),urine microalbumin-to-creatinine ratio(ACR),serum creatinine(Scr),urine creatinine(Ucr)and insulin dosage(P>0.05).After treatment,the levels of HbA1c,2 h PG,FBG,LVPWT,LVEDD,ACR,Scr and Ucr in the experimental group were lower,the dosage of insulin was less,while the E/A and LVEF were higher than those in the control group,and the differences were all statistically significant(P<0.05).After treatment,the levels of VEGF and VEGF-A in the experimental group were lower than those in the control group(P<0.05).There was no statistical difference in the total incidence of adverse reactions such as hypoglycemia,diarrhea and hypotension in the patients between the experimental group and the control group(P>0.05).Conclusion The treatment of GLP-1 receptor agonist liraglutide combined with engaglipin in diabetic nephropathy patients has good glucose-lowering effects and safety.It also improves cardiac and renal function,inhibits the overexpression of VEGF and VEGF-A,and reduces insulin dosage.
作者
曾婷
鞠浩
姚伟力
唐茜
雷向阳
ZENG Ting;JU Hao△;YAO Weili;TANG Xi;LEI Xiangyang(Department of Endocrinology;Department of Cardiology,the People′s Hospital of Longhua District,Shenzhen,Guangdong 518109,China)
出处
《检验医学与临床》
CAS
2024年第21期3177-3181,共5页
Laboratory Medicine and Clinic
基金
广东省深圳市龙华区医疗卫生机构区级科研项目(2022038)。
关键词
GLP-1受体激动剂
利拉鲁肽
恩格列净
糖尿病肾病
心功能
肾功能
glucagon-like peptide-1 receptor agonist
liraglutide
empagliflozin
diabetic nephropathy
cardiac function
renal function
作者简介
曾婷,女,主治医师,主要从事内分泌及代谢病学研究;通信作者:鞠浩,E-mail:835800732@qq.com。
