利拉鲁肽对2型糖尿病肾病患者肠道菌群的影响(1)
[摘要] 目的 觀察利拉鲁肽对2型糖尿病肾病(DN)患者肠道菌群的影响。 方法 选取2017年3月～2019年6月在本院就诊的DN患者60例为研究对象，随机分为两组，A组使用西格列汀片口服，B组使用利拉鲁肽针皮下注射。治疗前检测血清空腹血糖(FPG)、糖化血红蛋白(HbA1c)、尿白蛋白/肌酐比值(UACR)、β2-微球蛋白(β2-MG)等。治疗后检测粪便肠道菌群双歧杆菌、普雷沃菌、乳杆菌和肠杆菌的数量。采用Pearson相关性分析分析DN肠道菌群与微量白蛋白尿指标的相关性。 结果 (1)治疗前两组患者FPG、HbA1c、UACR，β2-MG比较，差异无统计学意义(P>0.05)。(2)治疗6个月后，B组双歧杆菌和普雷沃菌的菌落数显著高于A组，A组肠杆菌菌落数高于B组，差异有统计学意义(P<0.05)。(3)B组的β2-微球蛋白和尿白蛋白肌酐比值较A组均明显下降，差异有统计学意义(P<0.05)。(4)双歧杆菌与β2-MG、UACR呈负相关(r=-0.437.-0.612)。普雷沃菌与β2-MG、UACR呈负相关(r=-0.488.-0.435)。而肠杆菌与β2-MG、UACR呈正相关(r=0.650.0.679)，以上数值差异均有统计学意义(P<0.05)。 结论 利拉鲁肽通过增加糖尿病肾病患者肠道菌群益生菌的数量，改善微量白蛋白尿，最终起到额外保护肾脏的作用。
[关键词] 糖尿病肾病;2型糖尿病;肠道菌群;微量白蛋白尿
[中图分类号] R581.2;R692 [文献标识码] B [文章编号] 1673-9701(2020)27-0049-05
[Abstract] Objective To observe the effect of liraglutide on intestinal microflora in the patients with type 2 diabetic nephropathy(DN). Methods A total of 60 patients with DN who were treated in our hospital from March 2017 to June 2019 were selected as the study subjects. The patients were randomly divided into two groups. Group A was given sitagliptin tablets for oral administration， and group B was given liraglutide subcutaneous injection. Before treatment， serum fasting blood glucose (FPG)， glycated hemoglobin (HbA1C)， urine albumin/creatinine ratio (UACR)， β2-microglobulin (β2-MG) and other indicators were measured. After treatment， the number of fecal intestinal microflora such as Bifidobacterium， Prevotella， Lactobacillus and Enterobacteriaceae was detected. Pearson correlation analysis was used to analyze the correlation between DN intestinal microflora and microalbuminuria index. Results (1) Before treatment， FPG， HbA1C， UACR， β2-MG and other indicators were compared between the two groups， and the difference was not statistically significant (P>0.05). (2) After 6 months of treatment， the number of colonies of Bifidobacterium and Prevotella in group B were significantly higher than that in group A， and the number of enterobacteriaceae in group A was higher than that in group B， the differences were statistically significant(P<0.05). (3)The ratio of β2-microglobulin and urinary albumin creatinine in group B was significantly lower than that in group A， and the difference was statistically significant(P<0.05). (4)Bifidobacterium was negatively correlated with β2-MG and UACR(r=-0.437， -0.612). Prevotella was negatively correlated with β2-MG and UACR(r=-0.488， -0.435). Enterobacteriaceae was positively correlated with β2-MG and UACR(r=0.650， 0.679). The differences of all the above values were statistically significant(P<0.05). Conclusion Liraglutide can improve the microalbuminuria by increasing the number of probiotics in the intestinal microflora of patients with diabetic nephropathy， and finally play an additional role in protecting the kidneys., 百拇医药(胡家 霍丽霞 王菲菲 张玲 倪林)
[关键词] 糖尿病肾病;2型糖尿病;肠道菌群;微量白蛋白尿
[中图分类号] R581.2;R692 [文献标识码] B [文章编号] 1673-9701(2020)27-0049-05
[Abstract] Objective To observe the effect of liraglutide on intestinal microflora in the patients with type 2 diabetic nephropathy(DN). Methods A total of 60 patients with DN who were treated in our hospital from March 2017 to June 2019 were selected as the study subjects. The patients were randomly divided into two groups. Group A was given sitagliptin tablets for oral administration， and group B was given liraglutide subcutaneous injection. Before treatment， serum fasting blood glucose (FPG)， glycated hemoglobin (HbA1C)， urine albumin/creatinine ratio (UACR)， β2-microglobulin (β2-MG) and other indicators were measured. After treatment， the number of fecal intestinal microflora such as Bifidobacterium， Prevotella， Lactobacillus and Enterobacteriaceae was detected. Pearson correlation analysis was used to analyze the correlation between DN intestinal microflora and microalbuminuria index. Results (1) Before treatment， FPG， HbA1C， UACR， β2-MG and other indicators were compared between the two groups， and the difference was not statistically significant (P>0.05). (2) After 6 months of treatment， the number of colonies of Bifidobacterium and Prevotella in group B were significantly higher than that in group A， and the number of enterobacteriaceae in group A was higher than that in group B， the differences were statistically significant(P<0.05). (3)The ratio of β2-microglobulin and urinary albumin creatinine in group B was significantly lower than that in group A， and the difference was statistically significant(P<0.05). (4)Bifidobacterium was negatively correlated with β2-MG and UACR(r=-0.437， -0.612). Prevotella was negatively correlated with β2-MG and UACR(r=-0.488， -0.435). Enterobacteriaceae was positively correlated with β2-MG and UACR(r=0.650， 0.679). The differences of all the above values were statistically significant(P<0.05). Conclusion Liraglutide can improve the microalbuminuria by increasing the number of probiotics in the intestinal microflora of patients with diabetic nephropathy， and finally play an additional role in protecting the kidneys., 百拇医药(胡家 霍丽霞 王菲菲 张玲 倪林)