达格列净治疗早期2型糖尿病肾病对肾功能、尿微量白蛋白水平的影响

Effect of Dapagliflozin on Renal Function and Urinary Microalbumin Level in the Treatment of Early Type 2 Diabetes Nephropathy

目的分析在早期2型糖尿病肾病患者的临床治疗中应用达格列净的效果。方法选择2023年1月至2023年7月我院收治的早期2型糖尿病肾病患者80例,通过双盲法分为试验组与对照组,各40例。对照组予以盐酸二甲双胍片治疗,试验组予以达格列净治疗,比较两组患者治疗前后肾功能指标、炎性因子指标、免疫功能指标(CD4^(+)、CD8^(+)、CD4^(+)CD25^(+)、CD4^(+)/CD8^(+)、NK细胞)、氧化应激指标(超氧化物歧化酶、维生素E)、不良反应发生率、治疗效果。结果治疗前,两组患者的肾功能指标、炎性因子指标、免疫功能指标、氧化应激指标,对比差异无意义(P>0.05);治疗后,试验组的血尿素氮、血肌酐、尿白蛋白排泄率、尿微量白蛋白比对照组低(P<0.05);试验组的C反应蛋白、白介素6、肿瘤坏死因子α比对照组低(P<0.05);试验组CD8^(+)比对照组低,CD4^(+)、CD4^(+)CD25^(+)、CD4^(+)/CD8^(+)、NK细胞比对照组高(P<0.05);试验组维生素E比对照组低,超氧化物歧化酶比对照组高(P<0.05);两组患者的不良反应发生率对比差异无意义(P>0.05);试验组的治疗效果比对照组高(P<0.05)。结论在早期2型糖尿病肾病患者中实施达格列净治疗有助于改善患者的肾功能,降低机体炎性反应,药物安全性较高。

Objective To analyze the effect of dapagliflozin in the clinical treatment of early type 2 diabetes nephropathy.Methods 80 patients with early type 2 diabetes nephropathy to our hospital from January 2023 to July 2023 were selected and divided into the experimental group and the reference group by double blind method,40 patients in each group were given different treatment schemes.The control group was treated with metformin hydrochloride tablets.The experimental group was treated with dapagliflozin on the basis of the control group.The two groups were compared before and after treatment the renal function indexes,inflammatory factor,indexes immune function indicators(CD4^(+),CD8^(+),CD4^(+)CD25^(+),CD4^(+)/CD8^(+),NK cells),oxidative stress indicators(superoxide dismutase,vitamin E),incidence of adverse reactions,and treatment effectiveness.Results Before treatment,comparing the renal function indicators,inflammatory factor indicators,immune function indicators,and oxidative stress indicators between the two groups of patients showed no significant difference(P>0.05);After treatment,the blood urea nitrogen,blood creatinine,urinary albumin excretion rate,and urinary microalbumin in the experimental group were lower than those in the control group(P<0.05);C-reactive protein,interleukin6,and tumor necrosis factor in the experimental groupαLower than the control group(P<0.05);The^(+)CD8 in the experimental group was lower than that in the control group,while CD4^(+),CD4^(+)CD25^(+),CD4^(+)/CD8^(+),and NK cells were higher than those in the control group(P<0.05);The experimental group had lower levels of vitamin E and higher levels of superoxide dismutase compared to the control group(P<0.05);There was no significant difference in the incidence of adverse reactions between the two groups of patients(P>0.05);The treatment effect of the experimental group was higher than that of the control group(P<0.05).Conclusions The treatment of dapagliflozin in patients with early type 2 diabetes nephropathy is helpful to improve the renal function of patients,reduce the inflammatory reaction of the body,and has high drug safety,which is worth promoting.