达格列净联合厄贝沙坦治疗2型糖尿病肾病的疗效及对患者血清Cys-C、Hcy水平的影响

Efficacy of Dapagliflozin Combined with Irbesartan in the Treatment of Type 2 Diabetic Nephropathy and Effects on Patients'Serum Cys-C and Hcy Levels

目的 探讨2型糖尿病肾病采取达格列净联合厄贝沙坦治疗的临床效果及对血清胱抑素C(cystatinC,Cys-C)、同型半胱氨酸(homocysteine, Hcy)水平的影响。方法 选取2022年1-12月泉州市第一医院收入的76例2型糖尿病肾病患者作为研究对象,依据随机数表法均分为对照组与观察组,每组38例。对照组采用常规治疗+厄贝沙坦治疗,观察组在对照组基础上接受达格列净治疗。对比两组血脂水平、Cys-C、Hcy指标、肾功能指标、血糖水平及胰岛β细胞功能。结果 观察组患者治疗后总胆固醇(total cholestero, TC)、三酰甘油(triacylglycerol, TG)、低密度脂蛋白胆固醇(low density lipoprotein, LDL-C)、Cys-C、Hcy、空腹血糖(fasting plasma glucose, FPG)、胰岛素抵抗指数(homeostasis model assessment for insulin resistance, HOMA-IR)水平及肾功能各项指标均低于对照组,胰岛β细胞功能指数(homa beta cell function index, HOMA-β)、高密度脂蛋白胆固醇(high density lipoprotein, HDL-C)水平高于对照组,差异有统计学意义(P<0.05)。结论 2型糖尿病肾病患者使用达格列净+厄贝沙坦治疗,可有效改善血脂、血糖及胰岛β细胞功能,降低Cys-C、Hcy水平,为患者预后治疗提供有利条件。

Objective To investigate the clinical effect of dapagliflozin combined with irbesartan in the treatment of type 2 diabetic nephropathy and its effect on serum cystatin-C(Cys-C)and homocysteine(Hcy)levels.Methods From January to December 2022,76 patients with type 2 diabetic nephropathy admitted to the First Hospital of Quan-zhou were selected as the research objects.According to the random number table method,they were divided into con-trol group and observation group,with 38 cases in each group.The control group was treated with conventional treat-ment+irbesartan,and the observation group was treated with dapagliflozin on the basis of control group.The blood lipid level,Cys-C,Hcy index,renal function index,blood glucose level and isletβcell function were compared be-tween the two groups.Results After treatment,the levels of total cholesterol(TC),triacylglycerol(TG),low density li-poprotein cholesterol(LDL-C),Cys-C,Hcy,fasting plasma glucose(FPG),homeostasis model assessment for insulin resistance(HOMA-IR)and renal function indexes in the observation group were lower than those in the control group,the levels of homa beta cell function index(HOMA-β)and high density lipoprotein cholesterol(HDL-C)were higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusion The treatment of type 2 diabetic nephropathy patients with dapagliflozin+irbesartan can effectively improve blood lipids,blood glucose and pancreatic isletβ-cell function,and reduce the levels of Cys-C and Hcy,which can provide favorable conditions for the patients'prognosis and treatment.