关键词:

糖尿病肾病, 达格列净, 德谷胰岛素利拉鲁肽注射液, 血糖, 疗效, 安全性

Abstract:

Objective　To observe the effect of dagliprazin combined with insulin degludec and liraglutide injection in the treatment of patients with diabetic nephropathy (DN) and poor blood glucose control. Methods　A total of 167 patients with DN and poor blood glucose control treated at Hanzhong Nanzheng District People's Hospital from February 2022 to February 2024 were selected for the randomized controlled trial, and were divided into a study group (83 cases) and a control group (84 cases) by the random number table method. There were 47 males and 36 females in the study group; they were (57.39±8.16) years old; their disease course was (12.51±2.23) years; there were 48 cases of DN stage Ⅱ and stage 35 cases of stageⅢ. There were 50 males and 34 females in the control group; they were (56.47±8.23) years old; their disease course was (12.36±2.19) years; there were 51 cases of DN stage Ⅱ and 33 cases of stage Ⅲ. The study group were treated with dagliprazin and insulin degludec and liraglutide injection, and the control group with dagaglizin and insulin glargine, for 3 months. The clinical efficacies, renal function, blood glucose, markers of renal injury, peripheral blood cytokines, and the incidence rates of adverse drug reactions were compared between the two groups by t and χ² tests. Results　Before the treatment, there were no statistical differences in the levels of serum creatinine (Scr) and blood urea nitrogen (BUN) and urine albumin-to-creatinine ratio (UACR) between the two groups (all P>0.05). After the treatment, the levels of Scr and BUN and UACR in the study group were lower than those in the control group [(65.24±8.93) μmol/L vs. (76.12±10.43) μmol/L, (6.23±1.12) mmol/L vs. (8.04±1.41) mmol/L, and (92.32±14.26) mg/g vs. (106.21±18.35) mg/g], with statistical differences (all P<0.05). Before the treatment, there were no statistical differences in the levels of fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPBG), and glycosylated hemoglobin (HbA1c) between the two groups (all P>0.05). After the treatment, the levels of FBG, 2hPBG, and HbA1c in the study group were lower than those in the control group [(6.14±0.76) mmoL/L vs. (7.01±0.89) mmoL/L, (8.16±1.49) mmol/L vs. (9.32±1.73) mmol/L, and (5.21±0.59)% vs. (5.82±0.68)%], with statistical differences (all P<0.05). Before the treatment, there were no statistical differences in the levels of N-acetyl-β-D-glucosidase (NAG), retinol-binding protein (RBP), and neutrophil gelatinase-associated lipocalin (NGAL) between the two groups (all P>0.05). After the treatment, the levels of NAG, RBP, and NGAL in the study group were lower than those in the control group [(15.12±2.54) U/L vs. (18.84±3.01) U/L, (1.08±0.21) mg/L vs. (1.37±0.26) mg/L, and (51.26±8.13) μg/L vs. (62.13±10.28) μg/L], with statistical differences (all P<0.05). Before the treatment, there were no statistical differences in the levels of free fatty acid (FFA) and peroxisome surge activator receptor γ (PPARγ) between the two groups (both P>0.05). After the treatment, the levels of FFA and PPARγ in the study group were lower than those in the control group [(9.03±1.76) μg/L vs. (11.26±2.51) μg/L and (1 306.49±201.43) ng/L vs. (1 148.52±159.47) ng/L], with statistical differences (both P<0.05). The total effective rate of the study group was higher than that of the control group [85.54% (71/83) vs. 70.24% (59/84); P<0.05]. The incidence rates of adverse drug reactions in the study group and the control group were 6.02% (5/83) and 4.76% (4/84), respectively, with no statistical difference (P>0.05). Conclusion　Dagliprazin combined with insulin degludec and liraglutide injection in the treatment of patients with DN and poor blood glucose control is effective, can improve their renal function, blood glucose, markers of kidney injury, and peripheral blood cytokines, and does not increase adverse drug reactions.

Key words:

Diabetic nephropathy, Daglizin, Insulin degludec and liraglutide injection, Blood glucose, Curative effect, Safety