摘要
目的研究胰激肽原酶、利拉鲁肽联合治疗方案治疗老年糖尿病肾病的疗效。方法选择2016年1月—2020年10月芜湖市第一人民医院就诊的老年糖尿病肾病患者70例,采用数字表法随机分为观察组和对照组,每组35例。对照组采用皮下注射利拉鲁肽注射液治疗,对观察组使用胰激肽原酶联合利拉鲁肽方案治疗。比较2组血糖、肾功能[血尿素氮(BUN)、血肌酐(sSCr)和肾小球滤过率(GFR)]、血尿酸(SUA)、尿微量蛋白指标[尿β2-微球蛋白(β2-MG)、尿α1-微球蛋白(α1-MG)、24h尿微量白蛋白定量(24h-UmAlb)]、胱抑素C(Cys-C)和视黄醇结合蛋白(RBP)水平、治疗后肾功能损害恢复情况[曲线下面积(AUC)、达峰时间(TTP)、曲线达峰绝对值(DPI)]及治疗效果。结果治疗后,观察组血糖水平低于对照组(P<0.05);观察组BUN、SCr、SUA、24h-UmA1b、α1-MG和β2-MG水平低于对照组,GFR水平高于对照组(P<0.05);观察组TTP和AUC值低于对照组,DPI值高于对照组(P<0.05);观察组Cys-C和RBP水平低于对照组(P<0.05)。观察组的治疗总有效率高于对照组(P<0.05)。结论胰激肽原酶联合利拉鲁肽能够明显改善老年糖尿病肾病患者肾功能,修复肾损伤,其机制可能与降低Cys-C和RBP的表达、进而阻断其对肾脏的影响有关。
Objective To study the curative effect of kallidinogenase combined with liraglutide in the treatment of elderly patients with diabetic nephropathy.Methods A total of70elderly patients with diabetic nephropathy treated in First People’s Hospital of Wuhu City from January2016to October2020were selected and randomly divided into observation group and control group by the digital table method,with35cases in each group.The control group was treated with subcutaneous injection of liraglutide,and the observation group was treated with kallidinogenase combined with liraglutide.The blood glucose,renal function[blood urea nitrogen(BUN),serum creatinine(sSCr),glomerular filtration rate(GFR)],serum uric acid(SUA),urinary microprotein indexes[urineβ2-microglobulin(β2-MG),urinaryα1-microglobulin(α1-MG),24h urinary microalbumin quantification(24h-UmAlb)],cystatin C(Cys-C)and retinol binding protein(RBP)levels,as well as the recovery of renal function damage[area under the curve(AUC),time to peak(TTP),absolute value of the curve to peak(DPI)]after treatment and treatment effect were compared between the two groups.Results After treatment,the blood glucose level of the observation group was lower than that of the control group(P<0.05);the levels of BUN,SCr,SUA,24h-UmA1b,α1-MG,β2-MG were lower than those of the control group,and GFR level was higher than that of the control group(P<0.05);TTP and AUC were lower than those of the control group,and DPI were higher than those of the control group(P<0.05);the levels of Cys-C and RBP were lower than those of the control group(P<0.05).The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).Conclusion Kallidinogenase combined with liraglutide can significantly improve renal function and repair renal injury in elderly patients with diabetes nephropathy.Its mechanism may be related to reducing the expression of Cys-C and RBP,and then blocking their effects on kidney.
作者
洪娟
苏钢
詹桂桂
Hong Juan;Su Gang;Zhan Guigui(Department of General Medicine,First People’s Hospital of Wuhu City,Wuhut Anhui,241060,P.R.China)
出处
《老年医学与保健》
CAS
2022年第3期602-607,共6页
Geriatrics & Health Care
基金
芜湖市卫生健康委员会2019年度科研和技术项目(2019WWKJ01)。
关键词
老年
糖尿病肾病
肾损伤
胰激肽原酶
利拉鲁肽
elderly
diabetic nephropathy
kidney injury
kallidinogenase
liraglutide