达格列净治疗2型糖尿病肾病患者的临床疗效观察

Observation of the Clinical Effect of Dapagliflozin on Patients with Type 2 Diabetic Nephropathy

目的:研究SGLT-2抑制剂达格列净治疗2型糖尿病肾病患者的临床疗效。方法:挑选60例血糖控制欠佳的2型糖尿病肾病患者,随机分为两组,加用达格列净10mg/d作为观察组,加用安慰剂1片/d作为对照组,共治疗12周,记录治疗前后所有被检患者的一般资料及临床指标,并进行统计分析。结果:对照组与观察组干预前各项基线指标相近(P>0.05)。对照组治疗前后各指标均无明显改变(P>0.05);观察组治疗后体重、体质指数、空腹血糖、糖化血红蛋白、血肌酐、24h尿蛋白定量、血尿酸均较治疗前下降,空腹C肽及餐后2h C肽均较治疗前升高(P<0.05),而治疗前后TG、TC、HDL-C和LDL-C均无明显改变(P>0.05);干预后观察组患者的体重、体质指数、空腹血糖、糖化血红蛋白、血肌酐、24h尿蛋白定量、血尿酸水平均较对照组下降,空腹C肽较对照组上升(P<0.05),两组干预后TG、TC、HDL-C、LDL-C及餐后2h C肽差异无统计学意义(P>0.05)。结论:达格列净可以有效控制2型糖尿病肾病患者的血糖,改善其胰岛功能,并降低其尿蛋白、血肌酐及尿酸,从而保护肾功能。

Objective:In this study, we investigated the clinical curative effect of observation of dapagliflozin on patients with type 2 diabetic nephropathy.Methods:60 patients with type 2 diabetic nephropathy having not reached the glycemic targets were divided into two groups:the observation group was received with dapagliflozin 10 mg/d and the control group was received with placebo with a course of 12 weeks. General informations and clinical indicators of all patients before and after treatment were recorded, all results were statistically analyzed.Results:There were no significant changes in baseline charateristics between the two groups(P>0.05).The levels of body weight,BMI,FBG,HbA1 c,Scr,24-hour urinary protein quantification and UA were all decreased,fasting C-peptide and 2-hour postprandial C-peptide were all increased(P<0.05),while there were no significant changes in TG,TC,HDL-C and LDL-C after treatment in the observation group(P>0.05).The levels of body weight,BMI,FBG,HbA1 c,Scr and 24 hours urinary protein quantitative,UA were decreased,fasting C-peptide were increased(P<0.05), while there were no significant changes in TG,TC,HDL-C,LDL-C and 2-hour postprandial C-peptide(P>0.05) after treatment in the observation group compared with the control group.Conclusion:Dapagliflozin can effectively control the blood sugar of patients with type 2 diabetic nephropathy,improve the function of pancreatic islets,and reduce their urinary protein serum creatinine and uric acid,thereby protecting renal function.