艾塞那肽治疗早期糖尿病肾病患者的疗效研究

目的观察艾塞那肽对2型糖尿病合并早期糖尿病肾病(diabetic nephropathy,DN)患者肾功能等临床指标的影响。方法 58例早期DN患者随机分为艾塞那肽组与格列美脲组,每组各29例,分别给予艾塞那肽和格列美脲治疗,两组均联合二甲双胍治疗。治疗24周后对比两组患者空腹血糖(fasting plasma glucose,FPG)、餐后2 h血糖(2 hpostprandial plasma glucose,2 h PG)、糖化血红蛋白(hemoglobin Alc,Hb A1c)、血脂、尿素(blood urea,BUN)、肌酐(creatinine,Cr)、尿白蛋白/肌酐比值(urinary albumin to creatinine ratio,UACR)、血清转化生长因子-β1(transforming growthfactorβ1,TGF-β1)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、体重、体重指数(body mass index,BMI)等变化。结果 24周治疗后,两组FPG、2 h PG、Hb A1c水平均较治疗前降低(P0.05),组间比较差异无统计学意义(P0.05);两组UACR均较治疗前降低(P0.05);艾塞那肽组体重、BMI、SBP较治疗前降低(P0.05),24周治疗后,艾塞那肽组UACR、TGF-β1、SBP、体重、BMI较格列美脲组降低(P0.05)。结论艾塞那肽通过降低血糖、血压,减轻体重,减少尿蛋白排泄及抗纤维化作用保护肾脏。

Effects of exenatide on patients with early diabetic nephropathy

Objective To evaluate the effects of exenatide on patients with type two daibetes and early diabetic nephropathy (DN).Methods A total of 58 patients with DN were randomly divided into exenatide group and glimepiride group,29 patients in each group,both groups were combined with metformin.Fasting plasma glucose(FPG),2 h postprandial plasma glucose(2 h PG),hemoglobin Alc(HbA1c),lipids,blood urea(BUN),creatinine(Cr),urinary albumin to creatinine ratio (UACR),transforming growth factor-β1(TGF-β1),systolic blood pressure(SBP),diastolic blood pressure(DBP),body weight and body mass index(BMI) were compared between the two groups after 24 weeks treatments.Results After the 24 weeks treatments,the levels of FPG,2 h PG and HbA1c in the both groups were lower than those before treatment(P ＜ 0.05),and there was no significant difference between the two groups (P ＞ 0.05).UACR in both groups was lower than before treatment (P ＜ 0.05).TGF-β1,UACR,SBP,body weight and BMI in group Exe were significantly lower than those in group Glm (P ＜ 0.05).Conclusions Exenatide may protect daibetic nephropathy by lower blood glucose,blood pressure and weight,reduce urinary protein excretion and anti-fibrosis effect.