达格列净对早期糖尿病肾病的疗效观察

Efficacy of dapagliflozin in the treatment of patients with early diabetic nephropathy

目的探讨达格列净对早期糖尿病肾病患者的疗效。方法回顾性选取2020年1月至2021年12月芜湖市第一人民医院收治的82例早期糖尿病肾病患者为研究对象,按患者治疗意愿分为常规组和达格列净组,每组41例,常规组采取原有降糖方案治疗,达格列净组在常规组基础上加用达格列净口服,两组均治疗12周。比较两组治疗前后肾功能指标、血糖指标、肾小球滤过指标变化,并记录治疗期间不良反应发生情况。结果达格列净组治疗后临床总有效率高于常规组[95.12%(39/41)比78.05%(32/41)],差异有统计学意义(χ^(2)=4.96,P<0.05)。达格列净组治疗后尿白蛋白肌酐比值、尿素氮、血清肌酐、空腹血糖、餐后2 h血糖、糖化血红蛋白、胱抑素C水平均低于常规组[(49.73±11.65)mg/g比(67.26±10.04)mg/g、(6.96±0.54)mmol/L比(7.25±0.48)mmol/L、(76.82±2.86)μmol/L比(78.59±3.06)μmol/L、(8.58±0.18)mmol/L比(8.80±0.32)mmol/L、(8.03±0.42)mmol/L比(8.56±0.44)mmol/L、(7.06±0.57)%比(7.52±1.06)%、(1.47±0.50)mg/L比(1.84±0.55)mg/L],差异有统计学意义(P<0.05)。两组治疗后肾小球滤过率水平比较差异无统计学意义(P>0.05)。达格列净组治疗后总不良反应发生率低于常规组[7.32%(3/41)比24.39%(10/41)],差异有统计学意义(χ^(2)=4.48,P<0.05)。结论达格列净具有保护肾功能、降糖、改善胱抑素C水平及降低尿微量白蛋白的作用,对早期糖尿病肾病患者具有较好的疗效。

Objective To investigate the efficacy of dapagliflozin in patients with diabetic nephropathy.Methods A total of 82 patients with early diabetic nephropathy who were treated in Wuhu No.1 People′s Hospital from January 2020 to December 2021 were selected as the research objects,and they were divided into the conventional group(41 cases)and the dapagliflozin group(41 cases)according to the random number table method.The patients in the conventional group were given original hypoglycemic treatment and the patients in the dapagliflozin group were given dapagliflozin treatment on the former basis,the patients in the two groups were treated for 12 weeks.The levels renal function index,blood glucose index,glomerular filtration index and the occurrence of adverse reactions during the treatment period were compared between the two groups.Results After treatment,the total clinical effective rate in the dapagliflozin group was higher than that in the conventional group:95.12%(39/41)vs.78.05%(32/41),there was statistical difference(χ^(2)=4.96,P<0.05).The levels of urine albumin/creatinine(UACR),blood urea nitrogen(BUN),serum creatinine(SCr),fasting blood glucose(FPG),2 h postprandial blood glucose(2 h PG),glycosylated hemoglobin(HbA1c),cystatin C(Cys-C)in the dapagliflozin group were lower than those in the conventional group:(49.73±11.65)mg/g vs.(67.26±10.04)mg/g,(6.96±0.54)mmol/L vs.(7.25±0.48)mmol/L,(76.82±2.86)μmol/L vs.(78.59±3.06)μmol/L,(8.58±0.18)mmol/L vs.(8.80±0.32)mmol/L,(8.03±0.42)mmol/L vs.(8.56±0.44)mmol/L,(7.06±0.57)%vs.(7.52±1.06)%,(1.47±0.50)mg/L vs.(1.84±0.55)mg/L,there were statistical differences(P<0.05).The level of glomerular filtration rate(GFR)between the two groups had no significant differences(P>0.05).The incidence of total adverse reactions in dapagliflozin group was lower than that in control group:7.32%(3/41)vs.24.39%(10/41),there was statistical difference(P<0.05).Conclusions Dapagliflozin has a good effect in the treatment of patients with early diabetic nephropathy.It can lower glucose,improve Cys-C,reduce urinary microalbumin and protect renal function.