达格列净联合西格列汀在糖尿病肾脏疾病患者治疗中的临床效果及对纤维化指标的影响

Clinical curative effect of dapagliflozin combined with sitagliptin and its influences on fibrosis indexes in patients with diabetic kidney disease

目的:探讨达格列净联合西格列汀在糖尿病肾脏疾病患者治疗中的临床效果及对纤维化指标的影响。方法:选取2022年1月至2023年4月本院收治的78例糖尿病肾脏疾病患者作为研究对象,随机分为对照组和观察组,各39例。其中对照组采用西格列汀治疗,观察组在对照组的基础上联合达格列净治疗。比较两组患者治疗后的临床疗效和治疗期间不良反应;比较两组患者治疗前后的血糖、肾功能及纤维化指标。结果:治疗后,观察组总有效率明显高于对照组(P<0.05);观察组糖化血红蛋白A1c(Glycosylated hemoglobin,HbA1c)、空腹血糖(Fasting blood-glucose concentration,FBG)、餐后血糖(Postprandial blood sugar,PBG)、血尿素氮(Blood urea nitrogen,BUN)、血肌酐(Serum creatinine,SCr)、24h尿蛋白定量(24 h-urinary albumin excretion,24hUAE)、转生长因子-β1(Transforming Growth Factor-β,TGF-β1)、半胱氨酸蛋白酶抑制蛋白C(Cysteine proteases inhibit protein C,Cys C)、组织金属蛋白酶抑制物-1(Tissue inhibitor of metalloproteinase-1,TIMP-1)水平均明显低于对照组(P<0.05);两组患者不良反应总发生率无明显差异(P>0.05)。讨论:达格列净联合西格列汀治疗糖尿病肾脏疾病患者能有效提高治疗效果,改善肾功能及肾脏纤维化,降低血糖,且具有一定药物安全性。

Objective:To explore the clinical curative effect of dapagliflozin combined with sitagliptin and its influences on fibrosis indexes in patients with diabetic kidney disease(DKD).Methods:A total of 78 patients with DKD admitted to the hospital were enrolled as the research objects between January 2022 and April 2023,and they were randomly divided into control group and observation group,39 cases in each group.The control group was treated with sitagliptin,while observation group was additionally treated with dapagliflozin.The clinical curative effect after treatment,adverse reactions during treatment,blood glucose,renal function and fibrosis indexes before and after treatment were compared between the two groups.Results:After treatment,total response rate of observation group was significantly higher than that of control group(P<0.05).The levels of glycosylated hemoglobin A1c(HbA1c),fasting blood-glucose concentration(FBG),postprandial blood sugar(PBG),blood urea nitrogen(BUN),serum creatinine(SCr),24h urinary albumin excretion(24hUAE),transforming growth factor-β1(TGF-β1),cysteine proteases inhibit protein C(Cys C)and tissue inhibitor of metalloproteinase-1(TIMP-1)in observation group were significantly lower than those in control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Dapagliflozin combined with sitagliptin can effectively improve curative effect in patients with DKD,improve renal function and renal fibrosis,and lower blood glucose,with certain medicine safety.