缬沙坦氨氯地平联合达格列净治疗老年2型糖尿病肾病合并高血压的疗效观察

Clinical Observation of Valsartan Amlodipine combined with Dapagliflozin in the Treatment of Elderly Type 2 Diabetic Nephropathy with Hypertension

目的:探讨缬沙坦氨氯地平联合达格列净治疗老年2型糖尿病肾病(diabetic nephropathy,DN)合并高血压的临床疗效。方法:选取2020年3月-2023年3月我院DN伴高血压患者80例,依据随机数字表法分为研究组(n=40)及对照组(n=40)。常规干预基础上对照组口服缬沙坦氨氯地平,研究组在对照组基础上采取达格列净,均治疗12周。统计两组治疗有效率、治疗前后肾功能指标[尿白蛋白排泄率(urinary albumin excretion rate,UAER)、尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,SCr)]、肾损伤指标[视黄醇结合蛋白4(retinol-binding protein 4,RBP-4)、Chemerin、同型半胱氨酸(homocysteine,Hcy)、胱抑素C(cystatin C,CysC)]及不良反应发生率。结果:研究组治疗总有效率(95.0%)高于对照组(80.0%)(P<0.05);治疗后两组UAER、BUN、SCr、RBP-4、Chemerin、Hcy、CysC水平均较治疗前下降,且研究组低于对照组(P<0.05)。结论:缬沙坦氨氯地平联合达格列净治疗DN伴高血压,可有效减轻肾功能损伤,恢复肾功能状态,利于提升整体治疗效果,且具有安全性。

Objective To investigate the clinical efficacy of valsartan amlodipine combined with dapagliflozin in the treatment of elderly type 2 diabetic nephropathy(DN)with hypertension.Methods 80 patients with DN and hypertension in our hospital from March 2020 to March 2023 were selected and divided into a study group(n=40)and a control group(n=40)based on a random number table method.On the basis of routine intervention,the control group received oral administration of valsartan amlodipine,while the study group received treatment with daggliflozin for 12 weeks on the basis of the control group.Calculate the effective rate of treatment,renal function indicators before and after treatment[urinary albumin excretion rate(UAER),blood urea nitrogen(BUN),serum creatinine(SCr)],renal injury indicators[retinol binding protein 4(RBP-4),Chemerin,homocysteine(Hcy),cystatin C(CysC)],and incidence of adverse reactions in both groups.Results The total effective rate of the study group(95.0%)was higher than that of the control group(800%)(P<0.05).After treatment,the UAER,BUN and SCr of the two groups decreased compared to before treatment,and the study group was lower than the control group(P<0.05).After treatment,the serum levels of RBP-4,Chemerin,Hcy and CysC in the two groups decreased compared to before treatment,and the study group was lower than the control group(P<0.05).Conclusion The combination of valsartan amlodipine and daggliflozin in the treatment of DN with hypertension can effectively reduce renal function damage,restore renal function status,and improve overall treatment effectiveness with safety.