度拉糖肽联合达格列净和替米沙坦治疗糖尿病合并心肾功能不全的效果分析

Effect of dulaptide combined with dapagliflozin and telmisartan in the treatment of diabetes mellitus complicating with cardiorenal insufficiency

  • 摘要:
    目的 探讨度拉糖肽联合达格列净和替米沙坦治疗糖尿病合并心肾功能不全的有效性与安全性及其对血糖水平、心功能的影响。
    方法 选取110例2型糖尿病合并心肾功能不全患者作为研究对象,按照随机数字表法分为研究组和对照组,每组55例。对照组患者接受达格列净片和替米沙坦片口服治疗,研究组患者在对照组基础上联用度拉糖肽注射治疗,均连续治疗3个月。治疗前、治疗3个月时分别检测2组患者尿素氮(BUN)、尿酸(UA)、左心射血分数(LVEF)、左心室舒张末期内径(LVEDD)、血浆氨基末端脑钠肽前体(NT-proBNP)、糖化血红蛋白(HbA1c)、餐后2 h血糖(2 hPG)、空腹血糖(FPG)水平,计算肾小球滤过率(GFR)、尿蛋白排泄率,并评估2组的治疗有效性和安全性。
    结果 治疗后, 2组尿蛋白排泄率和BUN、UA、2 hPG、FPG、HbA1c、NT-proBNP水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05); 治疗后, 2组GFR、LVEF水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05); 治疗后, 2组LVEDD均小于治疗前,且研究组小于对照组,差异有统计学意义(P<0.05)。研究组治疗总有效率为92.73%, 高于对照组的76.36%, 差异有统计学意义(P<0.05)。2组患者不良反应总发生率比较,差异无统计学意义(χ2=0.910, P=0.340)。
    结论 与达格列净联合替米沙坦治疗方案比较, 度拉糖肽联合达格列净和替米沙坦治疗糖尿病合并心肾功能不全患者可降低血糖水平,改善心肾功能指标,具有更高的治疗有效性和安全性。

     

    Abstract:
    Objective To explore the effectiveness and safety of dulaptide combined with dagliflozin and telmisartan in the treatment of diabetes mellitus complicating with cardiorenal insufficiency and its effects on blood glucose levels and cardiac function.
    Methods A total of 110 patients with type diabetes combined with cardiorenal dysfunction were selected as study objects, and were divided into study group and control group according to random number table method, with 55 cases in each group. The control group orally administrated Dagliazine Tablets and Telmisartan Tablets, while the study group received dulaglutide injection based on the treatment of the control group. Both groups were treated for 3 months. Blood nitrogen (BUN), uric acid (UA), left heart ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), plasma amino-terminal brain natriuretic peptide precursor (NT-proBNP), HbA1c (HbA1c), 2 h postprandial blood glucose (2 hPG), fasting blood glucose (FPG) were measured, and the glomerular filtration rate (GFR) and urinary protein excretion rate were calculated. The efficacy and safety were evaluated in both groups.
    Results After treatment, urinary protein excretion rate and BUN, UA, 2 hPG, FPG, HbA1c, NT-proBNP levels in two groups were lower than before treatment, and above indicators in the study group were lower than those in the control group(P < 0.05). After treatment, GFR and LVEF levels in two groups were higher than before treatment, and were higher in the study group than those in the control group (P < 0.05). After treatment, the values of LVEDD in two groups were lower than before treatment, and LVEDD was lower in the study group than that in the control group (P < 0.05). The total effective rate of the study group was 92.73%, which was higher than 76.36% of the control group (P < 0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (χ2=0.910, P=0.340).
    Conclusion Compared with daglipin combined with telmisartan, dulaptide combined with dapagliflozin and telmisartan can reduce blood glucose level, improve cardiac and renal indexes, and have higher therapeutic effectiveness and safety in treating diabetic patients with cardiac and renal insufficiency.

     

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