利拉鲁肽对微量白蛋白尿期糖尿病肾病患者肾功能的影响

目的 对利拉鲁肽治疗微量白蛋白尿期（Ⅲ期）糖尿病肾病（DN）疗效及安全性进行观察。方法 将86例微量蛋白尿期DN患者随机分为两组。对照组给予常规降糖治疗，观察组在对照组基础上给予利拉鲁肽治疗，治疗6个月后比较两组体重指数（BMI）、空腹血糖(FBG)、餐后2 h血糖(PBG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA IR)、尿微量白蛋白排泄率（UMAER）、血肌酐（SCr）、计算尿白蛋白肌酐比值(ACR)及肾小球滤过率(eGFR)。结果 治疗前，两组血糖及肾功能指标比较差异无统计学意义(P＞0.05)。治疗后，两组BMI、FBG、PBG、HbA1c、HOMA IR 、BUN、SCr、UMAER及ACR降低，而FINS及 eGFR水平升高(P＜0.05)，但观察组改善更加明显（P＜0.01）。观察组低血糖的发生率低于对照组。结论 利拉鲁肽可在降血糖的基础上保护肾脏，改善肾功能且发生低血糖的概率低。

Effects of liraglutide on renal function in patients with microalbuminuria of diabetic nephropathy

Objective To observe the efficacy and safety of liraglutide on renal function in patients with microalbuminuria of diabetic nephropathy(DN). Methods A total of 86 DN patients with microalbuminuria were randomly divided into two groups. The control group was given conventional therapy, while the observation group got liraglutide combined with conventional therapy. After six months of treatment, comparison in two groups was made in body mass index (BMI), fasting blood glucose (FBG), 2 h postprandial blood glucose (PBG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS) and insulin resistance index (HOMA IR), urinary albumin excretion rate (UMAER), serum creatinine (SCr), the calculation of urine protein creatinine ratio (ACR) and glomerular filtration rate (eGFR). Results Before the treatment, there was no significant difference in blood glucose and renal function indexes between two groups (P>0.05). After the treatment, both groups saw decreases in BMI, FBG, PBG, HbA1c, HOMA IR, BUN, SCr, UMAER and ACR , while FINS and eGFR levels increased (P<0.05), the improvement in observation group was more significant (P<0.01). The incidence of hypoglycemia in observation group was lower than that of control group. Conclusion Liraglutide can protect the kidney by bringing down the blood glucose to an approapriate level, and improve renal function, and the probability of hypoglycemia is low.