利格列汀对糖尿病肾病患者肿瘤坏死因子受体、单核细胞趋化蛋白-1的影响
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摘要
目的:探讨糖尿病肾病采用利格列汀治疗对其肿瘤坏死因子受体、单核细胞趋化蛋白-1的影响。方法:选取我院收治的糖尿病肾病患者98例,随机分为对照组和试验组各49例。对照组采用二甲双胍治疗,在此基础上,试验组采用利格列汀治疗,连续治疗3个月后,比较两组肾功能[尿清蛋白排泄率(UAER)、24 h尿蛋白定量(24 hUpor)、血肌酐(SCr)]、糖脂代谢水平[糖化血红蛋白(HbA1c)、空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)]、单核细胞趋化蛋白-1(MCP-1)、肿瘤坏死因子受体(sTNFR1)、高敏C-反应蛋白(hs-CRP)、不良反应。结果:治疗3个月后,试验组UAER、24 hUpor、Scr较对照组低,差异具有统计学意义(P<0.05);治疗3个月后,试验组HbA1c、FPG、TC、TG较对照组低,差异具有统计学意义(P<0.05);治疗3个月后,试验组MCP-1、sTNFR1、hs-CRP水平较对照组低,差异具有统计学意义(P<0.05);两组不良反应发生率相比,差异无统计学意义(P>0.05)。结论:糖尿病肾病采用利格列汀治疗可改善糖脂代谢水平和肾功能,减轻炎症反应,降低MCP-1、sTNFR1水平,且不良反应少,安全性较高。
Objective: To explore the effect of Linagliptin on tumor necrosis factor receptor and monocyte chemoattractant protein-1 in patients with diabetic nephropathy. Methods: A total of 98 patients with diabetic nephropathy admitted to the Hospital from January 2017 to September 2018 were enrolled. The patients were divided into two groups according to the random double-blind method, with 49 cases in each group. The control group was treated with Metformin, whereas the experimental group was treated with Linagliptin plus Metformin. After 3 months of continuous treatment, the renal function [urinary albumin excretion rate, 24 h urine protein quantitation and serum creatinine], glycolipids metabolic levels [glycated hemoglobin, fasting blood glucose, total cholesterol and triglycerides], monocyte chemoattractant protein-1, tumor necrosis factor receptor, high-sensitivity C-reactive protein, and adverse reactions were compared between the two groups. Results: After 3 months of treatment, the levels of UAER, 24 hUpor and Scr in the experimental group were shown to be lower than those in the control group, and the difference was statistically significant(P<0.05). After 3 months of treatment, the levels of HbA1c, FPG, TC and TG in the experimental group were shown to be lower than the control group, and the difference was statistically significant(P<0.05). After 3 months of treatment, the levels of MCP-1, sTNFR1 and hs-CRP in the experimental group were lower than those in the control group, and the difference was statistically significant(P<0.05). There was no significant difference in incidence of adverse reactions between the two groups(P>0.05). Conclusion: For patients with diabetic nephropathy, Linagliptin is with higher safety, which can help improve their glycolipids metabolic levels and renal function, reduce the inflammatory response and the levels of MCP-1 and sTNFR1, and yet incur fewer adverse reactions.
Objective: To explore the effect of Linagliptin on tumor necrosis factor receptor and monocyte chemoattractant protein-1 in patients with diabetic nephropathy. Methods: A total of 98 patients with diabetic nephropathy admitted to the Hospital from January 2017 to September 2018 were enrolled. The patients were divided into two groups according to the random double-blind method, with 49 cases in each group. The control group was treated with Metformin, whereas the experimental group was treated with Linagliptin plus Metformin. After 3 months of continuous treatment, the renal function [urinary albumin excretion rate, 24 h urine protein quantitation and serum creatinine], glycolipids metabolic levels [glycated hemoglobin, fasting blood glucose, total cholesterol and triglycerides], monocyte chemoattractant protein-1, tumor necrosis factor receptor, high-sensitivity C-reactive protein, and adverse reactions were compared between the two groups. Results: After 3 months of treatment, the levels of UAER, 24 hUpor and Scr in the experimental group were shown to be lower than those in the control group, and the difference was statistically significant(P<0.05). After 3 months of treatment, the levels of HbA1c, FPG, TC and TG in the experimental group were shown to be lower than the control group, and the difference was statistically significant(P<0.05). After 3 months of treatment, the levels of MCP-1, sTNFR1 and hs-CRP in the experimental group were lower than those in the control group, and the difference was statistically significant(P<0.05). There was no significant difference in incidence of adverse reactions between the two groups(P>0.05). Conclusion: For patients with diabetic nephropathy, Linagliptin is with higher safety, which can help improve their glycolipids metabolic levels and renal function, reduce the inflammatory response and the levels of MCP-1 and sTNFR1, and yet incur fewer adverse reactions.
引文
1 张晶露,邱琳,雒晓春.糖尿病肾病发病机制研究进展[J].医学综述,2017,23(8):1623-1627.
2 冯轲昕,程根阳,杨璐绫,等.糖尿病肾病发病机制研究进展[J].中国医师进修杂志,2016,39(12):1134.
3 余翠,熊钱颖,王李卓,等.糖尿病肾病的发病机制及治疗进展[J].医学综述,2015,21(21):3944-3947.
4 孙慧,李彩萍.雷公藤多苷联合二甲双胍治疗糖尿病肾病临床观察[J].西部中医药,2014,27(7):82-84.
5 蒲素.二甲双胍联合甘精胰岛素治疗晚期糖尿病肾病空腹血糖的疗效观察[J].川北医学院学报,2015,30(1):64-67.
6 朱广平,向光大,乐岭,等.利格列汀联合胰岛素在糖尿病肾病患者治疗中的应用研究[J].华南国防医学杂志,2017,31(4):240-243.
7 中华中医药学会肾病分会.糖尿病肾病诊断、辨证分型及疗效评定标准(试行方案) [J].上海中医药杂志,2007,41(7):7-8.
8 吕萌,胡高云,涂志军,等.糖尿病肾病的发病机制及抗糖尿病肾病化合物的研究进展[J].中国新药杂志,2014,23(10):1139-1145.
9 林子桐,张超,沈雪梅.糖尿病肾病发病机制研究进展[J].中国药理学与毒理学杂志,2014,28(5):765-773.
10 李雪英,杨丽霞,姜良恩,等.炎症因子在糖尿病肾病发病机制中的中西医研究述评[J].世界中西医结合杂志,2016,11(4):572-575.
11 米桂平,王桂英.肿瘤坏死因子受体1、2与糖尿病肾病关系的研究进展[J].中西医结合心脑血管病杂志,2016,14(6):609-612.
12 杜立树,平龙玉,熊伟.炎症标志物检测对2型糖尿病早期肾脏疾病诊断的临床意义[J].检验医学与临床,2014,11(23):3292-3293.
13 翟丽敏,叶山东.二甲双胍的抗炎作用及其糖尿病肾脏保护作用[J].国际内分泌代谢杂志,2014,34(5):334-336.
14 段宇芬.利格列汀结合舒洛地特治疗对糖尿病肾病患者血管内皮细胞生长因子影响的研究[J].中国药物与临床,2016,16(3):388-390.
15 冯绮文,李晓永,陈寒蓓.利格列汀治疗2型糖尿病合并早期糖尿病肾病的效果观察[J].中国综合临床,2016,32(11):961-964.
2 冯轲昕,程根阳,杨璐绫,等.糖尿病肾病发病机制研究进展[J].中国医师进修杂志,2016,39(12):1134.
3 余翠,熊钱颖,王李卓,等.糖尿病肾病的发病机制及治疗进展[J].医学综述,2015,21(21):3944-3947.
4 孙慧,李彩萍.雷公藤多苷联合二甲双胍治疗糖尿病肾病临床观察[J].西部中医药,2014,27(7):82-84.
5 蒲素.二甲双胍联合甘精胰岛素治疗晚期糖尿病肾病空腹血糖的疗效观察[J].川北医学院学报,2015,30(1):64-67.
6 朱广平,向光大,乐岭,等.利格列汀联合胰岛素在糖尿病肾病患者治疗中的应用研究[J].华南国防医学杂志,2017,31(4):240-243.
7 中华中医药学会肾病分会.糖尿病肾病诊断、辨证分型及疗效评定标准(试行方案) [J].上海中医药杂志,2007,41(7):7-8.
8 吕萌,胡高云,涂志军,等.糖尿病肾病的发病机制及抗糖尿病肾病化合物的研究进展[J].中国新药杂志,2014,23(10):1139-1145.
9 林子桐,张超,沈雪梅.糖尿病肾病发病机制研究进展[J].中国药理学与毒理学杂志,2014,28(5):765-773.
10 李雪英,杨丽霞,姜良恩,等.炎症因子在糖尿病肾病发病机制中的中西医研究述评[J].世界中西医结合杂志,2016,11(4):572-575.
11 米桂平,王桂英.肿瘤坏死因子受体1、2与糖尿病肾病关系的研究进展[J].中西医结合心脑血管病杂志,2016,14(6):609-612.
12 杜立树,平龙玉,熊伟.炎症标志物检测对2型糖尿病早期肾脏疾病诊断的临床意义[J].检验医学与临床,2014,11(23):3292-3293.
13 翟丽敏,叶山东.二甲双胍的抗炎作用及其糖尿病肾脏保护作用[J].国际内分泌代谢杂志,2014,34(5):334-336.
14 段宇芬.利格列汀结合舒洛地特治疗对糖尿病肾病患者血管内皮细胞生长因子影响的研究[J].中国药物与临床,2016,16(3):388-390.
15 冯绮文,李晓永,陈寒蓓.利格列汀治疗2型糖尿病合并早期糖尿病肾病的效果观察[J].中国综合临床,2016,32(11):961-964.