达格列净用于血糖控制欠佳糖尿病肾病患者治疗中对其血糖、尿蛋白水平的影响

Effect of Dapagliflozin on Blood Glucose and Urinary Protein Levels in Diabetic Nephropathy Patients with Poor Blood Glucose Control

目的评估达格列净用于血糖控制欠佳糖尿病肾病患者治疗中对其血糖、尿蛋白水平影响。方法选取2020年1月—2022年5月于福建省立医院接受诊治的血糖控制欠佳糖尿病肾病患者100例作为研究对象,按照随机数表法将其分为对照组和观察组,每组50例。对照组采用常规降糖治疗,观察组采用常规降糖加达格列净治疗,对比两组治疗前、治疗24周后的空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、24 h尿蛋白定量(24 hUPQ)、尿白蛋白肌酐比(UACR)、肾小球滤过率(eGFR)、血肌酐(Scr)、体质指数、血压水平以及不良反应发生率。结果治疗后,两组的FPG、2 hPG、HbA1c、24 hUPQ、UACR、体质指数和血压水平均较治疗前降低,且观察组的FPG、2 hPG、HbA1c、24 hUPQ、UACR、体质指数和血压水平均低于对照组,差异有统计学意义(P<0.05)。治疗前后两组的eGFR和Scr水平比较,差异无统计学意义(P>0.05)。两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论血糖控制欠佳糖尿病肾病患者加用达格列净治疗,能显著增强其对血糖水平的控制效果,改善其蛋白尿情况,且具有较高的用药安全性。

Objective To evaluate the effects of Dapagliflozin on blood glucose and urinary protein levels in diabetic nephropathy patients with poor glycemic control.Methods A total of 100 diabetic nephropathy patients with poor blood glucose control who received treatment in Fujian Provincial Hospital from January 2020 to May 2022 were se⁃lected as research objects,and were divided into control group and observation group according to random number table method,with 50 cases in each group.The control group was treated with conventional hypoglycemic therapy,and the observation group was treated with conventional hypoglycemic therapy plus Dapagliflozin.The asting plasma glu⁃cose(FPG),2-hour postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbA1c),24-hour urine protein quantification(24 hUPQ),urinary albumin creatinine ratio(UACR),glomerular filtration rate(eGFR),serum creatinine(Scr),body weight index,blood pressure level and adverse reaction rate of the two groups were compared before and af⁃ter treatment for 24 weeks.Results After treatment,the levels of FPG,2 hPG,HbA1c,24 hUPQ,UACR,body mass in⁃dex and blood pressure in both groups were decreased compared with before treatment,and the levels of FPG,2 hPG,HbA1c,24 hUPQ,UACR,body mass index and blood pressure in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference in eGFR and Scr levels between the two groups before and after treatment(P>0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion In diabetic nephropathy patients with poor blood glucose control,the addition of Dapagliflozin can significantly enhance the control effect of blood glucose level,improve the condition of albuminuria,and has a high drug safety.