2型糖尿病或糖尿病肾病患者应用达格列净片治疗后短期尿液生化指标改变研究

Study on short-term changes of urine biochemical indicators in patients with type 2 diabetes mellitus or diabetic nephropathy after treatment with dapagliflozin tablets

目的观察2型糖尿病(T2DM)或糖尿病肾病(DN)患者应用达格列净片治疗后短期尿液生化指标改变。方法选择2020年10月至2021年12月于北京中医药大学东直门医院住院的40例T2DM或DN患者。在接受糖尿病及DN标准化治疗的背景下,测定患者口服达格列净片1周后,尿液生化指标的前后变化。结果治疗1周后,全部患者24 h尿钠、尿氯排泄、尿液阴离子间隙(UAG)及尿尿酸排泄水平显著高于治疗前[(193±57)mmol/24 h比(156±49)mmol/24 h、(170±51)mmol/L比(139±44)mmol/L、(65±22)mmol/L比(55±20)mmol/L、(3039±1233)μmol/24 h比(1540±1053)μmol/24 h],24 h尿肌酐排泄水平显著低于治疗前[(4436±1540)μmol/L比(5378±2366)μmol/L],差异均有统计学意义(均P<0.05);单纯T2DM患者24 h尿钠、尿氯排泄、尿尿酸排泄水平显著高于治疗前[(189±31)mmol/24 h比(136±14)mmol/24 h、(169±29)mmol/L比(122±20)mmol/L、(3447±1223)μmol/24 h比(2757±1129)μmol/24 h],差异均有统计学意义(均P<0.05);DN患者24 h尿钠、尿氯排泄水平显著高于治疗前[(196±70)mmol/24 h比(170±60)mmol/24 h、(171±63)mmol/L比(151±52)mmol/L],24 h尿肌酐排泄水平显著低于治疗前[(4412±1303)μmol/L比(5674±2618)μmol/L],差异均有统计学意义(均P<0.05);单纯T2DM患者和DN患者24 h尿蛋白定量与治疗前比较差异均无统计学意义(均P>0.05)。结论应用达格列净短期可改善患者尿液离子代谢排泄。

Objective To observe the short-term changes of urine biochemical indicators in patients with type 2 diabetes mellitus(T 2DM)or diabetic nephropathy(DN)after treatment with dapagliflozin tablets.Methods Totally 40 patients with T 2DM or DN admitted to Dongzhimen Hospital,Beijing University of Chinese Medicine from October 2020 to December 2021 were enrolled.Under the background of receiving standardized treatment for diabetes mellitus and DN,the changes of urine biochemical indicators were measured before and after 1 week treatment with dapagliflozin tablets.Results After 1 week of treatment,24 h urinary sodium,urinary chloride excretion,urinary anion gap(UAG),and uric acid excretion in all patients were significantly higher than those before treatment[(193±57)mmol/24 h vs(156±49)mmol/24 h,(170±51)mmol/L vs(139±44)mmol/L,(65±22)mmol/L vs(55±20)mmol/L,(3039±1233)μmol/24 h vs(1540±1053)μmol/24 h],the 24 h urinary creatinine excretion level was significantly lower than that before treatment[(4436±1540)μmol/L vs(5378±2366)μmol/L](all P<0.05);the levels of urinary sodium,urinary chloride excretion,and urinary acid excretion in pure T 2DM patients at 24 h were significantly higher than those before treatment[(189±31)mmol/24 h vs(136±14)mmol/24 h,(169±29)mmol/L vs(122±20)mmol/L,(3447±1223)μmol/24 h vs(2757±1129)μmol/24 h],the differences were statistically significant(all P<0.05);the 24 h urinary sodium and chloride excretion levels in DN patients were significantly higher than those before treatment[(196±70)mmol/24 h vs(170±60)mmol/24 h,(171±63)mmol/L vs(151±52)mmol/L],and the 24 h urinary creatinine excretion level was lower than that before treatment[(4412±1303)μmol/L vs(5674±2618)μmol/L](all P<0.05);there were no statistically significant differences in 24 h urine protein quantification in T 2DM patients and DN patients compared to before treatment(both P>0.05).Conclusion The application of dapagliflozin can improve patients′urinary ion metabolism and excretion in the short-term.