探究度拉糖肽联合达格列净对2型糖尿病肾脏疾病患者肾功能及肾纤维化标志物的影响。

本研究为前瞻性随机对照试验。连续选取2024年1月至2024年12月于本院就诊的2型糖尿病肾脏疾病患者为研究对象，采用随机分组法分为观察组与对照组。所有患者均接受糖尿病基础常规治疗；对照组予以达格列净单药治疗，观察组在达格列净治疗基础上联用度拉糖肽注射液干预。分别于治疗前、治疗12个月后检测并比较两组患者肾功能、肾纤维化标志物及炎症因子水平，并观察两组治疗期间不良反应发生情况。组间比较采用t检验和皮尔逊χ²检验。

本研究共纳入94例2型糖尿病肾脏疾病患者，观察组、对照组各47例。所有患者均完成12个月规范治疗。治疗后，两组患者估算的肾小球滤过率水平均较治疗前升高，且治疗后观察组估算的肾小球滤过率水平高于对照组(P均<0.05)。两组患者治疗后尿白蛋白/肌酐比值、血清肌酐、血尿素氮及肾纤维化标志物(转化生长因子-β1、结缔组织生长因子、肾损伤分子-1)、炎症因子(超敏C反应蛋白、白细胞介素-1β、肿瘤坏死因子-α)水平均较治疗前降低，且观察组上述指标水平低于对照组(P均<0.05)。两组患者糖化血红蛋白、空腹血糖水平均较治疗前下降(P均<0.05)，但治疗后糖化血红蛋白、空腹血糖两组间差异无统计学意义。治疗期间，两组患者不良反应发生率差异无统计学意义。

度拉糖肽联合达格列净可更好地保护2型糖尿病肾脏疾病患者肾功能、抑制肾纤维化并减轻炎症反应；其血糖控制效果与达格列净单药相当，且安全性良好。

To explore the influence of dulaglutide combined with dapagliflozin on renal function and fibrosis in patients with type 2 diabetic kidney disease (T2DKD).

This study was a prospective randomized controlled trial. Consecutive patients with T2DKD admitted to our hospital from January 2024 to December 2024 were enrolled and randomly assigned to an observation group and a control group. All patients received basic routine treatment for diabetes. The control group was treated with dapagliflozin monotherapy, while the observation group received additional intervention with dulaglutide injection on the basis of dapagliflozin. Levels of renal function, renal fibrosis markers, and inflammatory factors were measured and compared between the two groups at baseline and 12-month follow-up. Adverse events during treatment were also recorded. Inter-group comparisons were performed using the t-test and Pearson χ² test.

A total of 94 patients with T2DKD were enrolled in this study, with 47 patients in the observation group and 47 in the control group. All the patients completed 12-month standardized treatment. After treatment, the estimated glomerular filtration rate (eGFR) was significantly increased in both groups compared with baseline, and post-treatment eGFR in the observation group was markedly higher than that in the control group (P<0.05). After treatment, the urine albumin-to-creatinine ratio (UACR), serum creatinine (Scr), blood urea nitrogen (BUN), renal fibrosis markers including transforming growth factor-β1 (TGF-β1), connective tissue growth factor (CTGF), kidney injury molecule-1 (KIM-1), as well as inflammatory factors including high-sensitivity C-reactive protein (hs-CRP), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) were obviously decreased in both groups relative to baseline; moreover, these indicators in the observation group were significantly lower than those in the control group (P<0.05). Glycated hemoglobin (HbA1c) and fasting plasma glucose (FPG) were significantly reduced in both groups after treatment (P<0.05), whereas no statistically significant inter-group differences in HbA1c and FPG were observed after treatment. There was no significant difference in the incidence of adverse events between the two groups during the treatment period.

Dulaglutide combined with dapagliflozin can better preserve renal function, inhibit renal fibrosis, and reduce systemic inflammatory response in patients with T2DKD. Its glucose-lowering efficacy is comparable to dapagliflozin monotherapy, with favorable safety profile.