达格列净对2型糖尿病肾病患者血清脂蛋白相关磷脂酶A2及肾损伤标志物的影响

Effect of dapagliflozin on serum lipoprotein-associated phospholipase A2 and markers of renal injury in patients with type 2 diabetes nephropathy

目的分析达格列净对2型糖尿病肾病患者血清脂蛋白相关磷脂酶A2(Lp-PLA2)及肾损伤标志物的影响。方法选取2020年2月至2021年6月抚州市中医院收治的90例2型糖尿病肾病患者作为研究对象,随机分为对照组与研究组,每组45例。对照组给予二甲双胍片治疗,研究组给予达格列净治疗,比较两组治疗前后血糖水平、血清Lp-PLA2水平及肾损伤标志物。结果治疗后,两组糖化血红蛋白A1c(HbA1c)、空腹血糖(FBG)、餐后2h血糖(2hPBG)水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组血清Lp-PLA2水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组尿素氮(BUN)水平、尿微量白蛋白与尿肌酐比值(ACR)均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。结论采用达格列净治疗2型糖尿病肾病患者疗效显著,能有效控制血糖水平,显著改善血管内皮功,有效减轻肾损伤程度,显著改善患者肾功能,值得临床推广应用。

Objective To analyze the effect of dapagliflozin on serum lipoprotein-associated phospholipase A2(Lp-PLA2)and markers of renal injury in patients with type 2 diabetes nephropathy.Methods 90 patients with type 2 diabetes nephropathy admitted to Fuzhou Hospital of Tradition-al Chinese Medicine from February 2020 to June 2021 were selected as the study subjects,and they were randomly divided into the control group and the study group,with 45 cases in each group.The control group was treated with metformin tablets,while the study group was treated with dapa-gliflozin,the levels of blood glucose,serum Lp-PLA2,and renal injury markers before and after treatment were compared between the two groups.Results After treatment,the levels of glycosylated hemoglobin A1c(HbA1c),fasting blood glucose(FBG),postprandial 2 h blood glucose(2 h PBG)of the two groups were lower than those before treatment,and the study group was lower than the control group,and the differences were statis-tically significant(P<0.05).After treatment,serum level of Lp-PLA2 of the two groups was lower than that before treatment,and the study group was lower than the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of urea nitrogen(BUN)and uri-nary microalbumin to albumin-to-creatinine ratio(ACR)of the two groups were lower than those before treatment,and the study group was lower than the control group,and the differences were statistically significant(P<0.05).Conclusion Dapagliflozin is effective in the treatment of type 2 diabetes nephropathy patients,can effectively control blood glucose level,significantly improve vascular endothelial function,effectively reduce the degree of renal injury,and significantly improve renal function,which is worthy of clinical promotion and application.