摘要
目的分析利格列汀联合胰岛素对2型糖尿病(T2DM)合并肾病患者的疗效和安全性。方法选取2017年6月~2018年12月于河北中石油中心医院住院和门诊治疗的T2DM合并早期糖尿病肾病患者96例作为研究对象,采用随机数字表法分为治疗组48例(胰岛素强化+利格列汀),对照组48例(胰岛素强化)。两组患者均在降血糖治疗基础上应用缬沙坦胶囊80 mg口服以降低尿蛋白,治疗16周。比较两组治疗前后各指标变化,指标包括空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、血肌酐(CR)、24 h尿微量白蛋白(M-A1b)、胱抑素C(Cys-C)、稳态模型胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能指数(HOMA-β)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、体重指数(BMI)、胰岛素用量。结果与治疗前比较,治疗后两组FPG、2hPG、HbA1c降低(P <0.05);治疗组LDL-C、TG降低,差异有统计学意义(P <0.05),对照组治疗前后LDL-C和TG无明显变化,差异无统计学意义(P> 0.05),且治疗组低于对照组(P <0.05);两组BMI差异无统计学意义(P>0.05);两组HOMA-IR降低,且治疗组低于对照组(P <0.05);两组HOMA-β升高,且治疗组高于对照组(P <0.05);对照组胰岛素用量升高,治疗组胰岛素用量降低,且治疗组低于对照组(P <0.05);治疗前后两组CR、Cys-C比较,差异无统计学意义(P> 0.05);治疗前两组M-A1b降低(P <0.05),但组间比较差异无统计学意义(P> 0.05)。结论利格列汀联合胰岛素可有效降低T2DM患者的血糖、减少胰岛素用量调节血脂,在糖尿病肾病患者中应用可协助降低尿蛋白。
Objective To analyze the clinical efficacy and safety of Linagliptin combined with Insulin in patients with type 2 diabetes mellitus(T2 DM)and concurrent nephropathy.Methods From June 2017 to December 2018 in Hebei Petrochina Central Hospital,96 patients with early diabetic nephropathy inpatient and outpatient were selected as the subjects.They were divided into treatment group 48 cases(Insulin+Linagliptin),control group 48 cases(insulin)by random number table method.Patients in both groups were treated with Valsartan Capsules 80 mg orally to reduce urinary protein on the basis of hypoglycemic therapy for 16 weeks.The changes of each index before and after treatment were compared between the two groups,indicators including fasting plasma glucose(FPG),2 h postprandial blood glucose(2 HPG),glycosylated hemoglobin(HbA1 c),serum creatinine(CR),24 h urine trace albumin urinary inhibition(MA1 b),cystatin(Cys-C),the steady-state model of insulin resistance index(HOMA-IR)and isletβcell function index(HOMA-β),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),three acyl glycerin(TG),body mass index(BMI)and insulin dosage.Results Compared with before treatment,FPG,2 hPG and HbA1 cindexes of the two groups decreased after treatment(P<0.05).The LDL-C and TG indexes in the treatment group were reduced,and the difference was statistically significant(P<0.05),while the differences in LDL-C and TG between before and after treatment of the control group was not statistically significant(P>0.05),and the difference in the treatment group was lower than that in the control group(P<0.05).BMI in the two groups,the difference was not statistically significant(P>0.05).HOMA-IR was reduced in the two groups,and the treatment group was lower than the control group(P<0.05).HOMA-βincreased in the two groups,and the treatment group was higher than the control group(P<0.05).The amount of insulin in the control group increased,and the amount of insulin in the treatment group decreased,and the treatment group was lower than that in the control group(P<0.05).The increase of CR and Cys-C between the two groups before and after treatment was not statistically significant(P>0.05).The M-A1 bin the two groups was decreased(P<0.05),but the difference between two groups was not statistically significant(P>0.05).Conclusion The combination of Linagliptin and Insulin in the treatment of T2 DM patients can effectively reduce the blood glucose,reduce the amount of insulin and regulate the blood lipid,and help reduce the urine protein in patients with diabetic nephropathy.
作者
李立
张朝云
卢姗
潘丹
石蕊
苏微微
李陆
赵可新
LI Li;ZHANG Chaoyun;LU Shan;PAN Dan;SHI Rui;SU Weiwei;LI Lu;ZHAO Kexin(Department of Clinical Pharmary,Hebei Petrochina Central Hospital,Hebei Province,Langfang 065000,China;Department of Endocrinology,Hebei Petrochina Central Hospital,Hebei Province,Langfang 065000,China;Department of Neurology,Hebei Petrochina Central Hospital,Hebei Province,Langfang 065000,China;Department of Clinical Pharmary,Tianjin Hospital,Tianjin 300202,China)
出处
《中国医药导报》
CAS
2020年第17期173-176,共4页
China Medical Herald
基金
河北省廊坊市科技支撑计划项目(2017013061)
河北省重点研发计划自筹项目(20191736)。
