摘要
目的探讨艾塞那肽联合前列地尔对2型糖尿病(T2DM)合并慢性肾脏病(CKD)的疗效及对微炎症状态、血管内皮功能的影响。方法选取2018年4月至2020年4月在东南大学医学院附属南京同仁医院就诊的110例T2DM合并CKD患者作为研究对象,按照治疗方法不同分为观察组和对照组,各55例。其中,对照组予以艾塞那肽治疗,观察组在对照组的基础上给予前列地尔治疗,均连续治疗1个月。比较两组治疗前及治疗1个月后的生化指标[空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、血肌酐(Scr)、血尿素氮(BUN)及24 h尿蛋白定量]变化和临床疗效,并比较两组炎症指标[高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、血清淀粉样蛋白A(SAA)]、血管内皮功能指标[肱动脉血流介导的内皮依赖性血管舒张功能(EDD)、硝酸甘油介导的非内皮依赖性血管舒张功能(EIDD)、内皮素-1(ET-1)、一氧化氮(NO)]变化及不良反应发生情况。结果FBG、2 h PBG、Scr、BUN及24 h尿蛋白定量组间、时点间的主效应差异有统计学意义(P<0.01),时点间与组间存在交互作用(P<0.01)。与治疗前相比,治疗后两组的FBG、2 h PBG、Scr、BUN及24 h尿蛋白定量均降低,且观察组低于对照组(P<0.05)。观察组的总有效率高于对照组[96.36%(53/55)比83.64%(46/55)](P<0.05)。hs-CRP、TNF-α、IL-6、SAA水平组间、时点间的主效应差异有统计学意义(P<0.01),时点间与组间存在交互作用(P<0.01)。与治疗前相比,治疗后两组的hs-CRP、TNF-α、IL-6、SAA水平均降低,且观察组低于对照组(P<0.05)。EDD、EIDD、ET-1、NO水平组间、时点间的主效应差异有统计学意义(P<0.01),时点间与组间存在交互作用(P<0.01)。与治疗前相比,治疗后两组的EDD、EIDD、NO水平均升高,且观察组高于对照组(P<0.05);ET-1水平降低,且观察组低于对照组(P<0.05)。两组的不良反应总发生率比较差异无统计学意义(P>0.05)。�
Objective To investigate the efficacy of exenatide combined with alprostadil on type 2 diabetes mellitus(T2DM)complicated with chronic kidney disease(CKD)and its effect on microinflammatory state and vascular endothelial function.Methods A total of 110 T2DM patients with CKD treated in Nanjing Tongren Hospital,Southeast University School of Medicine from Apr.2018 to Apr.2020 were included and divided into an observation group and a control group according to treatment methods,with 55 cases in each group.The control group was given exenatide treatment,and the observation group was given alprostadil combined treatment on the basis of the control group,both of which were treated continuously for one month.The changes of biochemical indexes[fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PBG),serum creatinine(Scr),blood urea nitrogen(BUN),and 24 h urine protein quantification]and clinical efficacy were compared between the two groups before treatment and after one month of treatment,and the changes of inflammatory indicators[high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),serum amyloid A protein(SAA)],vascular endothelial function indicators[brachial artery blood flow-mediated endothelium-dependent vasodilation(EDD),nitroglycerin-mediated endothelium-independent vasodilation(EIDD),endothelin-1(ET-1),nitric oxide(NO)]and adverse reactions were compared between the two groups.Results The main effects of FBG,2 h PBG,Scr,BUN and 24 h urinary protein quantification were significantly different between groups and time points(P<0.01),and there were interactions between time points and groups(P<0.01).Compared with before treatment,the FBG,2 h PBG,Scr,BUN and 24 h urine protein quantification in the two groups were decreased after treatment,and the observation group was lower than the control group(P<0.05).The total effective rate of the observation group was higher than that of the control group[96.36%(53/55)vs 83.64%(46/55)](P<0.05).The main effects of hs-CRP,TN
作者
张皓
倪敏
张慧
原林林
董玉洁
ZHANG Hao;NI Min;ZHANG Hui;YUAN Linlin;DONG Yujie(Department of Endocrinology,Nanjing Tongren Hospital,Southeast University School of Medicine,Nanjing 211102,China)
出处
《医学综述》
CAS
2022年第19期3908-3913,3919,共7页
Medical Recapitulate
关键词
2型糖尿病
慢性肾脏病
艾塞那肽
前列地尔
微炎症状态
血管内皮功能
Type 2 diabetes mellitus
Chronic kidney disease
Exenatide
Alprostadil
Microinflammatory state
Vascular endothelial function
