利拉鲁肽治疗老年早期2型糖尿病肾病的临床分析

doi:10.3969/j.issn.1003-9198.2021.06.008

摘要/Abstract

摘要： 目的观察利拉鲁肽治疗老年早期2型糖尿病肾病的疗效,以及对糖脂代谢、24 h尿微量白蛋白和肾功能指标的影响。方法将四川大学华西医院收治的124例老年早期2型糖尿病肾病病人纳入研究,采用随机数表法将其分为观察组和对照组,每组62例。对照组中血脂、血压异常者予以降血脂、控制血压治疗,同时注射胰岛素或口服降糖药物控制血糖,观察组在此基础上联用利拉鲁肽。比较2组病人治疗8周后的总有效率,以及治疗前和治疗8周后糖代谢指标、脂代谢指标、24 h尿微量白蛋白、肾功能指标[胱抑素C(CysC)、随机尿白蛋白/肌酐比值(UACR)]变化情况。结果治疗8周后,观察组治疗总有效率高于对照组(P＜0.01);2组FPG、餐后2 h血糖、HbA1c、空腹胰岛素(FINS)、TC、TG、LDL-C、24 h尿微量白蛋白、CysC、UACR水平均较治疗前降低,且观察组低于对照组(P＜0.01);2组HDL-C水平均显著升高,且观察组高于对照组(P＜0.01)。结论应用利拉鲁肽治疗老年早期2型糖尿病肾病的疗效确切,可有效改善糖脂代谢,保护肾功能,具有一定临床应用价值。

关键词: 利拉鲁肽, 2型糖尿病, 糖尿病肾病, 糖脂代谢, 肾功能, 老年人

Abstract: Objective To observe the efficacy of liraglutide in the elderly patients with early type 2 diabetic nephropathy and the effects on glucolipid metabolism, 24 h microalbuminuria and renal function. Methods A total of 124 elderly patients with early type 2 diabetic nephropathy from December 24, 2019 to November 13, 2020 in West China Hospital, Sichuan University were enrolled and divided into observation group and control group according to the random number table method, with 62 cases in each group. The patients in control group received routine treatment for hyperlipoidemia and hypertension, and insulin injection or oral administration of hypoglycemic drugs. The patients in observation group received liraglutide on the basis of control group. The total effective rate 8 weeks after treatment, as well as glucose metabolism indexes [fasting plasma glucose (FPG), postprandial 2 h blood glucose (2hPG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS)], lipid metabolism indicators [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)], 24 h microalbuminuria and renal function indicators [Cystatin C (CysC), random urine albumin/creatinine ratio (UACR)] before treatment and 8 weeks after treatment were compared between the two groups. Results After 8 weeks of treatment, the total effective rate in observation group was higher than that in control group (P<0.01). The levels of FPG, 2hPG, HbA1c, FINS, TC, TG, LDL-C, 24h microalbuminuria, CysC and UACR in the two groups were lower than those before treatment, and the level of HDL-C was higher than that before treatment, especially in observation group (P<0.01). Conclusions Liraglutide shows an exact efficacy in the treatment of early type 2 diabetic nephropathy in the elderly. And it can effectively improve the glucolipid metabolism and protect the renal function, with a certain clinical application value.

Key words: liraglutide, type 2 diabetes mellitus, diabetic nephropathy, glucolipid metabolism, renal function, aged

中图分类号:

R 587.2

阮毅, 李菁, 黄肖容. 利拉鲁肽治疗老年早期2型糖尿病肾病的临床分析[J]. 实用老年医学, 2021, 35(6): 568-571.

RUAN Yi, LI Jing, HUANG Xiao-rong. Clinical analysis of liraglutide in the treatment of early type 2 diabetic nephropathy in elderly[J]. Practical Geriatrics, 2021, 35(6): 568-571.

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