达格列净联合二甲双胍治疗早期糖尿病肾病的效果及对肾功能和氧化应激的影响

Effects of dapagliflozin combined with metformin on early diabetic nephropathy,renal function,and oxidative stress

目的 观察达格列净联合二甲双胍治疗早期糖尿病肾病的临床效果,探讨二药联用对患者肾功能和氧化应激的影响。方法 早期2型糖尿病肾病患者92例中口服二甲双胍治疗46例(对照组),口服达格列净联合二甲双胍治疗46例(观察组),比较2组患者的糖脂代谢指标(FPG、HbA1c、LDL-C)、肾功能指标及氧化应激指标水平。结果 治疗前,2组患者的糖脂代谢、肾功能、氧化应激指标水平,差异均无统计学意义(P>0.05)。治疗后,2组患者的FPG、HbA1c、LDL-C、BUN、Scr、24 h尿中微量白蛋白、MPO、MDA水平均降低,且观察组低于对照组;SOD水平升高,且观察组高于对照组;差异均有统计学意义(P<0.05)。结论 与单药使用二甲双胍比较,达格列净联合二甲双胍更能降低早期2型糖尿病肾病患者的糖脂代谢指标和肾功能指标水平,更有效抑制机体的氧化应激程度。

Objective To observe the clinical effects of dapagliflozin combined with metformin in the treatment of early diabetic nephropathy, and to explore the effects of dapagliflozin combined with metformin on renal function and oxidative stress in patients. Methods In 92 patients with early type 2 diabetes nephropathy, 46 patients were treated with metformin(control group) and 46 patients were treated with dapagliflozin combined with metformin(observation group). The levels of glucose and lipid metabolism indicators(FPG, HbA1 c, LDL-C), renal function indicators and oxidative stress indicators were compared between the two groups. Results Before treatment, there was no significant difference in the levels of glucose and lipid metabolism, renal function, and oxidative stress indicators between the two groups(P>0.05). After treatment, the levels of FPG, HbA1 c, LDL-C, BUN, Scr, 24 h urinary microalbumin, MPO, and MDA in the two groups were decreased, and those in the observation group were lower than those in the control group;The SOD level were increased, and that in the observation group was higher than that in the control group. The differences were statistically significant(P<0.05). Conclusions Compared with metformin alone, dapagliflozin combined with metformin can more effectively reduce the levels of glucose and lipid metabolism indicators and renal function indicators in patients with early type 2 diabetic nephropathy, and more effectively inhibit the degree of oxidative stress in the body.