艾塞那肽对糖尿病肾脏病合并肥胖患者的临床疗效观察

发布时间：2018-06-21 12:14

  本文选题：2型糖尿病 + 早期糖尿病肾病　； 参考：《新疆医科大学》2015年硕士论文

【摘要】：目的：探讨关于GLP-1受体激动剂艾塞那肽对糖尿病肾病(Diabetic nephropathy,DN)合并肥胖患者的临床疗效。方法：选取2012年9月至2013年12月在新疆医科大学内分泌科诊断为2型糖尿病(type 2 diabetes mellitus,T2DM)合并糖尿病肾病的患者,根据纳入标准及排除标准最终入组80例,按治疗方案的不同,分为普通中效胰岛素+二甲双胍组(对照组)及普通中效胰岛素+二甲双胍组+艾塞那肽组(艾塞那肽组)。收集两组年龄、病程、腹围、身体质量指数(body mass index,BMI)、糖化血红蛋白(glycosylated hemoglobin,HbAlc)、空腹血糖(fasting blood-glucose,FPG),餐后2小时血糖(2-hour postprandial blood glucose,2h-PG)、尿微量白蛋白(microalbumin,mALb)、收缩压(systemic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、高敏C反应蛋白(high seneitivity-C-reactive protein,hs-CRP)、同型半胱氨酸(homocysteine,Hcy)、尿肌酐(urine creatinine,Ucr)等基线数据,随访16周后对比两组上述各项指标。结果：(1)治疗后两组FPG、2-PG、HbAIc均较治疗前明显降低(均P0.05)；对照组与艾塞那肽组对FPG的控制无显著性差异(P0.05),而两组治疗后2h-PG及HbAIc差异有统计学意义(P0.05)。(2)治疗16周后,艾塞那肽组腹围及BMI均较治疗前有明显降低,差异有统计学意义(均P0.05)；对照组腹围及BM[无明显改变,差异无统计学意义(均P0.05)。(3)艾塞那肽组SBP较治疗前显著下降,差异有统计学意义(P0.05), DBP治疗前后无明显改变,差异无统计学意义(均P0.05)；对照组SBP及DBP治疗前后均无明显改变,差异无统计学意义(均P0.05)。(4)艾塞那肽组经16周治疗后hs-CRP、Hcy均较治疗前显著下降,差异有统计学意义(均P0.05)；(5)艾塞那肽组与对照组mALb、ACR均较治疗前显著下降,差异有统计学意义(均P0.05)；结论：艾塞那肽在控制糖尿病患者血糖同时可以有效减轻体重、减少尿蛋白、抑制炎症反应及氧化应激,从而可以起到延缓DN患者肾功进展的降糖外效应。
[Abstract]:Objective: to investigate the clinical effect of Isenapeptide, a GLP-1 receptor agonist, on diabetic nephropathytic DNs complicated with obesity. Methods: from September 2012 to December 2013, 80 patients with type 2 diabetes mellitus type 2 diabetes mellitusus T2DMwere diagnosed in the Department of Endocrinology, Xinjiang Medical University. They were divided into two groups: normal medium effect insulin metformin group (control group) and general medium effect insulin metformin group (Isenapeptide group). Two groups of age, course of disease, abdominal circumference were collected. Body mass index (mass), glycosylated hemoglobinine (glycosylated hemoglobin), glycosylated hemoglobinine (HbAlcN), fasting blood glucose (fasting), blood glucose (glucose), 2-hour postprandial blood glucose (2h-PGN), urinary microalbumin (Alb), systolic blood pressure (SBP), diastolic blood pressure (DBP), Gao Min C-reactive protein high seneitivity-C-reactive protein (hs-CRPN), homocysteine (HCH), homocysteine (HCT). Baseline data such as urine creatinine After 16 weeks follow-up, the above indexes were compared between the two groups. Results [WT5 "HZ] after treatment, the levels of FPG in the two groups were significantly lower than those before treatment (P 0.05, P 0.05), but there was no significant difference in the control of FPG between the control group and the Eisenapeptide group (P 0.05), but there was a statistically significant difference in 2 h-PG and HbAIc between the two groups at 16 weeks after treatment. The abdominal circumference and BMI of the Isenapeptide group were significantly lower than those of the control group (P 0.05), the abdominal circumference and BM of the control group were not changed, and the difference was not statistically significant (P0.05. 0. 0. 3) the SBP of the Isenapeptide group was significantly lower than that of the control group (P 0. 05, P < 0. 05, P < 0. 05). The difference was statistically significant (P 0.05), but there was no significant change in DBP before and after treatment (all P 0.05), but there was no significant change in SBP and DBP in control group before and after treatment. After 16 weeks of treatment, hs-CRP Hcy was significantly lower in the Isenapeptide group than in the pre-treatment group (P 0.05, P 0.05). The ACR of mALbn in the Eisenapeptide group and the control group was significantly lower than that in the control group after 16 weeks of treatment. Conclusion: Isenapeptide can effectively reduce body weight, reduce urinary protein, inhibit inflammatory reaction and oxidative stress in diabetic patients. Thus, it can delay the progression of renal function in DN patients.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1;R589.2
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本文编号：2048574