利格列汀联合胰岛素治疗2型糖尿病合并肾病的临床效果

Abstract
Figure/Table
References (21)
Related Citation (15)

Download: PDF (344 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To analyze the clinical efficacy and safety of Linagliptin combined with Insulin in patients with type 2 diabetes mellitus (T2DM) and concurrent nephropathy. Methods From June 2017 to December 2018 in Hebei Petrochina Central Hospital, 96 patients with early diabetic nephropathy inpatient and outpatient were selected as the subjects. They were divided into treatment group 48 cases (Insulin + Linagliptin), control group 48 cases (insulin) by random number table method. Patients in both groups were treated with Valsartan Capsules 80 mg orally to reduce urinary protein on the basis of hypoglycemic therapy for 16 weeks. The changes of each index before and after treatment were compared between the two groups, indicators including fasting plasma glucose (FPG), 2 h postprandial blood glucose (2 HPG), glycosylated hemoglobin (HbA1c), serum creatinine (CR), 24 h urine trace albumin urinary inhibition (M-A1b), cystatin (Cys-C), the steady-state model of insulin resistance index (HOMA-IR) and islet β cell function index (HOMA-β), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), three acyl glycerin (TG), body mass index (BMI) and insulin dosage. Results Compared with before treatment, FPG, 2hPG and HbA1c indexes of the two groups decreased after treatment (P ＜ 0.05). The LDL-C and TG indexes in the treatment group were reduced, and the difference was statistically significant (P < 0.05), while the differences in LDL-C and TG between before and after treatment of the control group was not statistically significant (P ＞ 0.05), and the difference in the treatment group was lower than that in the control group (P ＜ 0.05). BMI in the two groups, the difference was not statistically significant (P ＞ 0.05). HOMA-IR was reduced in the two groups, and the treatment group was lower than the control group (P ＜ 0.05). HOMA-β increased in the two groups, and the treatment group was higher than the control group (P ＜ 0.05). The amount of insulin in the control group increased, and the amount of insulin in the treatment group decreased, and the treatment group was lower than that in the control group (P ＜ 0.05). The increase of CR and Cys-C between the two groups before and after treatment was not statistically significant (P ＞ 0.05). The M-A1b in the two groups was decreased(P ＜ 0.05), but the difference between two groups was not statistically significant (P ＞ 0.05). Conclusion The combination of Linagliptin and Insulin in the treatment of T2DM patients can effectively reduce the blood glucose, reduce the amount of insulin and regulate the blood lipid，and help reduce the urine protein in patients with diabetic nephropathy.

Key words： Linagliptin Type 2 diabetes Insulin Urine protein Security

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	LI Li1 ZHANG Chaoyun2 LU Shan1 PAN Dan1 SHI Rui1 SU Weiwei3 LI Lu4 ZHAO Kexin1

Cite this article:

LI Li1 ZHANG Chaoyun2 LU Shan1 PAN Dan1 SHI Rui1 SU Weiwei3 LI Lu4 ZHAO Kexin1. Clinical effect of Linagliptin combined with Insulin in the treatment of type 2 diabetes mellitus with nephropathy[J]. 中国医药导报, 2020, 17(17): 173-176.

URL:

http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I17/173

[1] 李文文，王奇金.DNA甲基化和2型糖尿病危险因素的研究与进展[J].中国糖尿病杂志，2017，9（12）：787-789.
[2] 郭丽婷，高志红，葛焕琦.2型糖尿病患者外周血microRNA-155、细胞核因子-κB和可溶性细胞间黏附分子-1的表达及其与血管并发症的关系研究[J].中国糖尿病杂志，2017，25（3）：213-217.
[3] 陈文娜.西格列汀对早期糖尿病肾病患者血清趋化素与转化生长因子-β-1的影响[J].中国医学创新，2018，15（33）：43-46.
[4] 刘媛.瑞格列奈联合甘精胰岛素对2型糖尿病患者胰岛β细胞功能及血清葡萄糖转运蛋白4的影响[J].中国医药导报，2017，14（6）：81-84.
[5] 中华医学会糖尿病学分会微血管并发症学组.糖尿病肾病防治专家共识（2014年版）[J].中华糖尿病杂志，2014， 6（11）：792-801
[6] 孙晓慧，王燕，牟艳玲.2型糖尿病大鼠心肌PI3K/Akt/ mTOR信号通路的改变及Sirt1的调控机制研究[J].中国药理学通报，2017，33（6）：793-798.
[7] 余美霞，刘迅，杜柳涛，等.经典途径IKKα和IKKβ在胰岛素抵抗和2型糖尿病中的作用机制及药物治疗[J].中国新药杂志，2017（5）：535-541.
[8] Gross B，Pawlak M，Lefebvre P，et al. PPARs in obesityinduced T2DM，dyslipidaemia and NAFLD [J]. Nat Rev Endocrinol，2017，13（1）：36-49.
[9] 范尧夫，唐春花，顾晔，等.阿格列汀对早期糖尿病肾病患者尿蛋白、同型半胱氨酸及血液流变学指标的影响[J].现代中西医结合杂志，2017，26（29）：3228-3230.
[10] 叶夏云，赵金英，赵阳.沙格列汀治疗糖尿病肾病的疗效观察[J].安徽医药，2017，21（11）：2074-2076.
[11] Owens DR，Swallow R，Dusi KA，et al. Efficacy and safety of linagliptin in persons with type 2 diabetes inadequately controlled by a combination of metformin and sulphonylurea：a 24-week randomized study [J]. Diabete Med，2011，28（11）：1352-1361.
[12] Taskinen MR，Rosenstock J，Tamminen I，et al. Safety and efficacy of linagliptin as add-on therapy to metformin in patients with type 2 diabetes：a randomized，double-blind，placebo controlled study [J]. Diabetes Obes Metab， 2011，13（1）：65-74.
[13] Frandsen CS，Madshad S. Efficacy and safety of dipeptidyl peptidase-4 inhibitors as an add-on to insulin treatment in patients with type 2 diabetes：a review [J]. Diabet Med，2014，31（11）：1293-1300.
[14] Otsuki H，Kosaka T，Nakamura K，et al. Safety and efficacy of linagliptin：a novel DPP-4 inhibitor for hemodialysis patients with type 2 diabetes [J]. Int Urol Nephrol，2014，46（2）：427-432.
[15] 蒋隽舒，叶盛开，孙晓红，等.DPP-4抑制剂沙格列汀对2型糖尿病大鼠肾损伤的保护作用[J].大连医科大学学报，2017，39（4）：323-328，333.
[16] 陈海静，孙海燕，刘红丹.西格列汀联合厄贝沙坦治疗早期糖尿病肾病疗效观察[J].中国药师，2017，20（8）：1433-1435.
[17] 庞毅，刘海燕，钟劢文，等.甘精胰岛素联合利格列汀对初诊2型糖尿病胰岛β细胞损伤保护作用的研究[J].中国医学创新，2020，17（1）：23-26.
[18] 张云，陈梁.GDM患者血清维生素D与HOMA-IR、HOMA-β、APN、RBP4及血糖水平的关系[J].中国妇幼保健，2017，32（16）：3743-3745.
[19] 邵爱萍.格列美脲联合利格列汀治疗2型糖尿病合并肥胖患者的临床效果[J].中国医药导报，2017，14（3）：88-94.
[20] 来艳.利格列汀联合门冬胰岛素50治疗肝源性糖尿病的疗效和安全性研究[J].中国药物与临床，2019，19（16）：2780-2782.
[21] 谢英才，支李金，李小漫.利格列汀在血糖控制不良的2型糖尿病中的疗效及对胰岛功能的影响[J].广东医学，2018，39（增刊）：223-226.