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目的 探讨胰高血糖素样肽-1受体激动剂在合并糖尿病的中国肾移植受者中的应用效果，并评估其安全性。方法 纳入2020年1月至2023年1月接受肾移植手术并使用胰高血糖素样肽-1受体激动剂治疗的中国糖尿病病例35例，比较胰高血糖素样肽-1受体激动剂治疗前和治疗1、6、12个月后血糖、肾功能、血脂和肝功能指标，并记录药物不良反应的发生情况。结果 胰高血糖素样肽-1受体激动剂治疗1、6、12个月后，35例病例的空腹血糖均低于治疗前（P<0.01）；治疗6、12个月后糖化血红蛋白低于治疗前（P<0.01），且逐月降低。肝功能和肾功能指标在治疗期间保持稳定，各时间点比较差异均无统计学意义（P > 0.05）。治疗12个月后，低密度脂蛋白胆固醇低于治疗前（P<0.05）。在药物不良反应方面，胃肠道反应发生率最高（占51.43%），其中4例病例（占11.43%）因不能耐受治疗而停药；低血糖发生率为8.57%。结论 胰高血糖素样肽-1受体激动剂在合并糖尿病的中国肾移植受者中的应用安全、有效，能够显著改善血糖控制效果，且对肾功能、肝功能和血脂指标无显著不良影响。尽管胃肠道反应发生率较高，但多数患者可耐受，低血糖发生率较低，提示胰高血糖素样肽-1受体激动剂可作为合并糖尿病的中国肾移植受者的重要治疗选择之一。
Abstract：AIM To investigate the efficacy of glucagon-like peptide-1 receptor agonists(GLP-1 RA) in Chinese kidney transplant recipients, including their effects on blood glucose, and to evaluate their safety. METHODS A total of 35 Chinese renal transplant recipients with diabetes mellitus who received GLP-1 RA treatment from January 2020 to January 2023 were enrolled. Indicators of blood glucose, renal function, blood lipid and liver function were compared before treatment and after 1, 6 and 12 months of GLP-1 RA treatment. The incidence of adverse drug reactions was recorded. RESULTS After 1, 6 and 12 months of GLP-1 RA treatment, fasting blood glucose in the 35 patients was significantly lower than that before treatment(P < 0.01). Glycated hemoglobin(HbA1c) levels at 6 and 12 months after treatment were lower than the baseline level(P < 0.01) and decreased gradually over time. Liver and renal function parameters remained stable during treatment, with no statistically significant differences at all time points(P > 0.05). At 12 months post-treatment, low-density lipoprotein cholesterol(LDL-C) was lower than baseline(P < 0.05). Regarding adverse reactions, gastrointestinal reactions were the most common(51.43%), among which 4 patients(11.43%) discontinued treatment due to intolerance. The incidence of hypoglycemia was 8.57%. CONCLUSION GLP-1 RA is safe and effective in Chinese renal transplant recipients complicated with diabetes mellitus. It can significantly improve glycemic control without obvious adverse effects on renal function, liver function or lipid profile. Although gastrointestinal reactions are relatively common, most patients are tolerant, and the incidence of hypoglycemia is low. GLP-1 RA can be considered as one of the important therapeutic options for this population.
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基本信息:
DOI：10.19577/j.1007-4406.2026.05.002
中图分类号:R587.1;R699.2
引用信息:
[1]张维,张雅鑫,白志杰,等.胰高血糖素样肽-1受体激动剂在合并糖尿病的中国肾移植受者中的应用效果[J].中国临床药学杂志,2026,35(05):390-394.DOI:10.19577/j.1007-4406.2026.05.002.
基金信息:
北京慢性病防治与健康教育研究会糖尿病防治及管理研究（三期）专项科研课题（编号MBZX0092024012）
2026-05-25
2026-05-25