探讨利拉鲁肽、达格列净、二甲双胍联合应用对2型糖尿病早期肾病患者血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、单核细胞趋化蛋白1(MCP-1)、尿微量白蛋白(mAlb)水平的作用。选择2022年1～10月本院2型糖尿病早期肾病患者124例作为研究对象，随机分为两组:对照组62例，予以利拉鲁肽联合二甲双胍治疗;观察组62例，予以利拉鲁肽、达格列净、二甲双胍联合治疗，均治疗3个月。观察并记录两组疗效性、不良反应及治疗前和治疗3个月后血糖相关指标[FPG(空腹血糖)、2hPG(餐后2h血糖)、HbA1c(糖化血红蛋白)]、肾功能指标[BUN(尿素氮)、Scr(血肌酐)]、肾损伤指标[NGAL、MCP-1、mAlb、24 h UP(24 h尿蛋白定量)]、红细胞免疫功能指标[RBC-C3bR(红细胞C3b受体)花环形成百分率、RBC-ICR(红细胞免疫复合物)花环形成百分率、CD35阳性RBC(红细胞)百分率]。观察组和对照组相比治疗总有效率明显升高(95。16％vs75。81％，P＜0。05);指标中NGAL、MCP-1、FPG、2hPG、HbA1c、BUN、Scr、24 h UP、mAlb水平两组经治疗后均下降，其中观察组上述指标下降更明显(P＜0。05);治疗后观察组RBC-ICR花环百分率低于对照组，而RBC-C3bR花环百分率、CD35阳性RBC百分率高于对照组(P＜0。05);两组患者治疗期间不良反应发生率无显著差异(观察组9。68％vs对照组6。45％，P＞0。05)。利拉鲁肽、达格列净、二甲双胍联合治疗能有效控制2型糖尿病早期肾病患者血糖水平，减轻肾损害，调节机体免疫，并具备一定用药安全性。
Combined Application of Liraglutide,Dagliflozin and Metformin in Patients with Early Stage Nephropathy in Type 2 Diabetes and the Effect on Serum NGAL,MCP-1 and mAlb Levels
To investigate the effects of the combination of liraglutide,dagliflozin and metformin on serum neutrophil gelatinase-asso-ciated lipid transport protein(NGAL),monocyte chemotactic protein 1(MCP-1)and urinary microalbumin(mAlb)levels in patients with early stage nephropathy in type 2 diabetes,124 patients with early stage nephropathy of type 2 diabetes mellitus in the hospital from January to October 2022 were selected as the study subjects and divided into two groups by random number table method.62 cases in the control group were treated with liraglutide combined with metformin,and 62 cases in the observation group were trea-ted with the combination of liraglutide,dagliflozin and metformin,all treated for 3 months.The efficacy,adverse reactions and blood glucose indexes[fasting blood glucose(FPG),glycosylated haemoglobin(HbA1c),2h postprandial blood glucose(2hPG)],renal function[blood creatinine(Scr),urea nitrogen(BUN),24 h urine protein quantification(24 h UP)],renal injury indexes(NGAL,MCP-1,mAlb),erythrocyte immune function[percentage of erythrocyte C3b receptor(RBC-C3bR)garlands,percentage of erythrocyte immune complex(RBC-ICR)garlands,percentage of CD35-positive red blood cells(RBCs)]were compared between two groups.Compard with the control group the total effective rate of observation group was significantly increased(95.16％vs 75.81％,P＜0.05).Among the indicators,the level of NGAL、MCP-1、FPG、2hPG、HbA1c、BUN、Scr、24 h UP and mAlb decreasd after treatment in both groups,and the above indicators decreased more significantly in the observation group(P＜0.05)than in the control group;After treatment,the percentage of RBC-ICR wreath in observation group was lower than that in control group,and the percentage of RBC-C3BR wreath and CD35 positive RBC were higher than that in control group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the observation group and control group(9.68％vs 6.45％,P＞0.05).Combined treatment with liraglutide,dagliazine and metformin can effectively control the blood glucose level in patients with early type 2 diabetic nephropathy,reduce kidney damage,regulate the body's immunity,and have certain drug safety.
Type 2 diabetes mellitusNephropathyLiraglutideMetforminDagliazineCurative effect
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