Effect of sitagliptin combined with Yiqi yangyin huoxue decoction on clinical efficacy and hemorheology in early diabetic nephropathy

BACKGROUND Early diabetic nephropathy(DN)is a complication of diabetes mellitus.It mainly affects kidney microvessels and glomerular function,and its timely and effective treatment is critical for early DN.However,the effects of treatments comprising simple Western medicine are not optimal.With the promotion and implementation of integrated Chinese and western medicine treatments,remarkable results have been achieved for many diseases.To this end,we explored the clinical efficacy of integrated traditional Chinese and western medicines for the treatment of early DN.AIM To investigate the effect of sitagliptin tablets combined with Yiqi yangyin huoxue decoction on clinical efficacy and hemorheology in patients with early DN.METHODS Through a retrospective analysis,123 patients with early DN were admitted to the endocrinology clinic of the Changzhou NO.7 People’s Hospital from January 2021 to October 2022 and were selected as study subjects.After rigorous screening,100 patients with early DN were enrolled.The control group(CG,n=50)and the observation group(OG,n=50)were divided according to the treatment method.The CG were treated with sitagliptin,and the OG were treated with sitagliptin plus the Yiqi yangyin huoxue decoction.Both groups were treated for 3 mo.For both groups,the baseline data and clinical efficacy were compared,and changes in blood glucose levels,lipid levels,renal function,and hematological indicators before(T0)and after(T1)treatment were assessed.RESULTS The total effective rate for the OG was 94.00%and that of the CG was 80.00%(P<0.05).After treatment(T1),the levels of fasting blood glucose,2 h postprandial glucose,total cholesterol,triacylglycerol,and low-density lipoprotein cholesterol in OG patients were obviously lower than those in the CG(P<0.05),and cystatin C,homocysteine,urinary microalbumin,and blood creatinine values in OG patients were also obviously lower than those in the CG(P<0.05);erythrocyte deposition,plasma viscosity,whole blood high shear viscosity,and whole blood low shear viscosity were markedly lower in OG patients than in the CG(P<0.05).CONCLUSION Sitagliptin combined with Yiqi yangyin huoxue decoction has a remarkable effect when used to treat patients with early DN.Further,it is helpful in improving hemorheological indices and controlling disease progression.

Knowledge Attitude and Practice of General Physicians for Early Detection of Diabetic Nephropathy in Cotonou

Introduction: General physicians can play an important role in the early detection of diabetic nephropathy (DN). Purpose: To assess the levels of general physicians’ knowledge, attitude and practice in terms of early detection of DN in Cotonou. Method: It was a cross-sectional, analytical and descriptive study which was conducted from 1st March 2015 to 30th September 2015. Every general physician working in a health structure in Cotonou who consented to participate in the study was included. We did not included medical specialists and general physicians working in nephrology department. Data were collected through a survey form designed with a score to assess the various items such as: knowledge, attitude and practice. The significance threshold is set to below 0.05. Results: In total, 202 general physicians were included. The average age was 30.9 ± 6.9 years ranging from 24 to 68 years. A male predominance was observed with 2.2 sex ratio. The majority of respondent medical physicians had poor knowledge in 76.2% cases, bad attitudes (61%) and bad practices (64.9%) in terms of early detection of diabetic nephropathy. There was positive impact of continuing medical training focused on diabetic nephropathy on attitudes (p = 0.016) and practices (p = 0.001) of these physicians. Conclusion: Diabetic nephropathy requires particular attention. General physicians’ continuous training is a principal solution.

Protective effect of calcium dobesilate combined with benazepril therapy on renal injury in patients with early diabetic nephropathy and the possible molecular mechanisms

Objective:To explore the protective effect of calcium dobesilate combined with benazepril therapy on renal injury in patients with early diabetic nephropathy and the possible molecular mechanisms.Methods:A total of 50 patients with early diabetic nephropathy treated in our hospital between May 2012 and January 2016 were collected, and according to the random number table, the patients were divided into observation group (n=25) and control group (n=25). On the basis of conventional treatment, control group of patients received benazepril therapy, observation group of patients received calcium dobesilate combined with benazepril therapy, and the treatment lasted for 3 months. Before and after treatment, automatic biochemical analyzer was used to detect the levels of renal injury indexes in peripheral blood, RIA method was used to detect the levels of renal injury indexes in urine, ELISA method was used to detect the levels of renal fibrosis indexes and Western-blot method was used to detect the protein expression of TGF-β1/BMP-7 and Smad signaling pathway molecules in renal tissue. Results: Before treatment, differences in renal injury index levels, renal fibrosis index levels and signaling pathway molecule protein expression were not statistically significant between two groups of patients. After treatment, BUN, SCr andβ-TP levels in the peripheral blood as well as KIM-1 level in urine of observation group were lower than those of control group;renal fibrosis indexes TGF-β1, CTGF, TIMP-1, LN and HA levels in serum of observation group were lower than those of control group;TGF-β1 and Smad2/3 protein expression in renal tissue of observation group were lower than those of control group while Smad7 and BMP-7 protein expression were higher than those of control group.Conclusion: Calcium dobesilate combined with benazepril therapy can reduce the renal injury and inhibit the fibrosis process in patients with early diabetic nephropathy, and it achieves the above effect by regulating the TGF-β1/BMP-7 and Smad signaling pathway function.

Assessment of renal function and oxidative stress after alprostadil combined with valsartan treatment of early diabetic nephropathy

Objective:To analyze the renal function and oxidative stress after alprostadil combined with valsartan treatment of early diabetic nephropathy.Methods:A total of 230 patients with early diabetic nephropathy who were treated in our hospital between December 2011 and December 2015 were divided into control group (n=115) and observation group (n=115) according to random number table. Control group received valsartan treatment, observation group received alprostadil combined with valsartan treatment, and both lasted for one month. After treatment, renal blood flow parameters were evaluated by ultrasound contrast technique, renal function index levels in peripheral blood and urine were measured, and serum levels of oxidative stress indexes were detected.Results:After 1 month of treatment, area under curve (AUC) and time to peak (TTP) levels under ultrasound contrast of observation group were lower than those of control group while derived peak intensity (DPI) level was higher than that of control group;peripheral blood urea nitrogen (BUN) and serum creatinine (Scr) levels of observation group were lower than those of control group, albumin (Alb) level was higher than that of control group, and urine red blood cell (RBC) level was lower than that of control group;serum oxidative stress indexes malondialdehyde (MDA) and advanced oxidation protein products (AOPP) levels of observation group were lower than those of control group while superoxide dismutase (SOD) and total antioxidant capacity (T-AOC) levels were higher than those of control group.Conclusion: Alprostadil combined with valsartan can optimize renal function and reduce systemic oxidative stress in patients with early diabetic nephropathy.

Evaluation of renal function and oxidative stress after adjuvant epalrestat treatment of early diabetic nephropathy

Objective:To explore the influence of adjuvant epalrestat treatment of early diabetic nephropathy on renal function and oxidative stress.Methods:A total of 80 patients with early diabetic nephropathy who were treated in our hospital between January 2013 and February 2016 were collected and divided into observation group and control group according to single-blind parallel control. Control group of patients received routine therapy, and observation group of patients received adjuvant epalrestat treatment on this basis. After 8 weeks of treatment, automatic biochemical analyzer was used to detect the renal function indexes of two groups of patients;RIA method was used to detect the serum renal fibrosis index levels;enzyme-linked immunosorbent assay (ELISA) was used to detect serum oxidative stress index levels.Results:Before treatment, differences in serum renal function, renal fibrosis and oxidative stress index levels were not statistically significant between two groups of patients;after 8 weeks of treatment, serum renal function indexes Scr, BUN, CysC andβ2-MG levels of observation group were lower than those of control group, renal fibrosis indexes CⅣ, CTGF and TGF-β1 levels were lower than those of control group, oxidation indexes ROS, LHP and AOPPs levels were lower than those of control group, anti-oxidation indexes SOD, VitE, VitC and T-AOC levels were significantly higher than those of control group, and the differences were statistically significant.Conclusion:Adjuvant epalrestat therapy can optimize the renal function and reduce the systemic oxidative stress response in patients with early diabetic nephropathy.

Assessment of the renal function, peroxidation damage and inflammatory injury after epalrestat combined with alprostadil treatment of early diabetic nephropathy

Objective:To study the renal function, peroxidation damage and inflammatory injury after epalrestat combined with alprostadil treatment of early diabetic nephropathy.Methods:90 patients with early diabetic nephropathy treated in our hospital between June 2011 and November 2015 were collected and divided into observation group and control group (n=45) according to the single-blind randomized control method. Observation group received epalrestat combined with alprostadil treatment, control group received alprostadil treatment alone, and the treatment of both groups lasted for 3 months. Before treatment and after 3 months of treatment, turbidimetric immunoassay was used to detect the renal function indexes in peripheral blood, rate method was used to detect the renal function indexes in urine, and ELISA method was used to detect the levels of peroxidation indexes and inflammation indexes.Results:Before treatment, differences in renal function, peroxidation damage and inflammatory damage indexes were not statistically significant between two groups of patients (P>0.05). After 3 months of treatment, creatinine (Scr), cystatin C (CysC),β2 microglobulin (β2-MG), N-acetyl-β-D-glucosaminidase (NAG), reactive oxygen species (ROS), advanced protein oxidation products (AOPPs), interleukin-8 (IL-8), interleukin-27 (IL-27) and procalcitonin (PCT) levels of observation group were lower than those of control group while catalase (CAT), total superoxide dismutase (TSOD), interleukin-4 (IL-4), interleukin-10 (IL-10) and interleukin-13 (IL-13) levels were higher than those of control group (P<0.05). Conclusions:Epalrestat combined with alprostadil can protect the renal function and inhibit the peroxidation damage and inflammatory injury in patients with early diabetic nephropathy.

Effects of Irbesartan combined Atorvastatin on serum levels of Cys C, Hcy, TNF-α, ET, TGF-b1 in patients with early diabetic nephropathyn

Objective: To observe the effects of Irbesartan combined with Atorvastatin on early diabetic nephropathy patients' serum Cys C, Hcy, TNF-α, ET and TGF-b1 levels. Methods: A total of 60 early diabetic nephropathy patients were randomly divided into observation group (30 cases) and control group (30 cases). Observation group: Irbesartan combined with Atorvastatin;control group: patients were treated only by Irbesartan. Recording and comparing the levels of Cys C, Hcy, TNF-α, ET and TGF-b1 before and after treatment. Results: (1) Before treatment, there was no statistically significant difference in the serum FBG, TG, Scr, BUN levels between the two groups. After treatment, compared with the same group before treatment, the serum TG, Scr, BUN levels of the two groups were significantly lower, and those levels of observation group were significantly better than the control group, the difference between two groups was statistically significant;(2) Before treatment, there was no statistically significant difference in the serum Cys C, Hcy, TNF-α, ET, TGF-b1 levels between the two groups. After treatment, compared with the same group before treatment, the serum Cys C, Hcy, TNF-α, ET, TGF-b1 levels of the two groups were significantly lower, and those levels of observation group were significantly better than the control group, the difference between two groups was statistically significant. Conclusion: Irbesartan combined with Atorvastatin for early diabetic nephropathy patients can reduce the levels of serum Cys C, Hcy, TNF-α, ET, TGF-b1 and be beneficial to protect their nephritic function.

THE VALUE OF URINE PROTEIN EXCRETION IN DIAGNOSING EARLY DIABETIC NEPHROPATHY

We tested urine albumin excretion rate (UAER), urine transrerrin (TRF ), retinolulnding protein (RBP), N --acetyl--aD-gi ucosamlnldase (N AG ), P, - mi c rogl obu I in (P, -- M G ) and lgGIn 45 cases of NIDDM. Thirty cases with UAER<300 mg/d were divided into two groups. Data wereshown with urine protein index (urine protein/urine creatlne). ResultS showed that urine transferrinwas more seusltlve than albumlu, and the combined test or urine Protein is nontraumatic, which hadsteatncance to diagnose early diabetic nepkropatby.

Lipocalin-2 as a biomarker for diabetic nephropathy

Diabetes is a major global public health issue.The prevalence of type 1 diabetes is comparatively static,as hereditary and genetic causes are involved,while type 2 diabetes(T2D)prevalence is increasing day by day.T2D is associated with chronic complications,including diabetic neuropathy(DN),nephropathy,retinopathy,and other complications like diabetic foot.DN is the main complication of both types of diabetes.DN can be diagnosed by routine laboratory tests,microalbuminuria>300 mg/24 h,and a gradual decrease in glomerular filtration rate.As the appearance of microalbuminuria is a late manifestation,an early marker for renal damage is needed.Lipocalin-2,also known as neutrophil gelatinaseassociated lipocalin(NGAL),is a small protein purified from neutrophil granules and a good marker for kidney disease.NGAL is a transporter protein responsible for many physiological processes,such as inflammation,generation of the immune response,and metabolic homeostasis.NGAL has been reported to depict the early changes in renal damage when urine microalbumin is still undetecable.Therefore,elucidating the role of NGAL in detecting DN and understanding its mechanism can help establish it as a potential early marker for DN.

Network Meta-analysis of Four Chinese Patent Medicines Combined with Angiotensin Converting Enzyme Inhibitors or Angiotensin Receptor Blockers in Early Diabetic Nephropathy Treatment

The objective of the study is to systematically evaluate the efficacy of four Chinese patent medicines in combination with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) in the treatment of early diabetic nephropathy (DN). Retrospectively, previously published randomized controlled trials (RCTs) of four different Chinese patent medicines combined with ACEI or ARB in the treatment of patients with early DN were searched overall from databases. The data were analyzed by R, Generate Mixed Treatment Comparisons and STATA softwares. A total of 78 RCTs were finally included. Network meta-analysis showed that the total effective rate of the Jinshuibao capsule-ACEI/ARB combination group and Huangkui capsule-ACEI/ARB combination groups were better than the others;Jinshuibao capsule-ACEI/ARB combination group reduced the 24-h urinary protein excretion (24-h UTP), urine microalbumin excretion rate (UAER), serum creatinine (Scr), and glycosylated hemoglobin (HbAlc) values. The Huangkui capsule-ACEI/ARB combination demonstrated a better reduction of (blood urea nitrogen [BUN]). Reduced incidences of adverse effects were only observed on treatment with Bailing capsule-ACEI/ARB combination. In early DN, combination of Jinshuibao capsule-ACEI/ARB provided the highest effective rate;moreover, it could reduce the24-h values of UTP, UAER, Scr, and HbAlc;Huangkuai capsule-ACI/ARB combination group showed a good effect on reducing BUN. Bailing capsule-ACEI/ARB combination group had reduced the incidences of adverse reactions.

UTILITY OF ALBUSURE TEST IN SCREENING FOR EARLY STAGE OF DIABETIC NEPHROPATHY

all diabetic patients should be screened for the early stage of diabetic nephropathy,because microalbuminuria has a great prognostic significance.The albusure test(AT),alatex agglutination nephelometric immunoassay,is a rapid and low cost test for the detection of microalbuminurai of 30mg/L or more.

SGLT-2抑制剂达格列净治疗早期糖尿病肾病的临床效果和安全性分析

目的分析在早期糖尿病肾病治疗中采用钠-葡萄糖协同转运蛋白2(Sodium-dependent Glucose Transporters 2,SGLT-2)抑制剂达格列净的疗效和安全性。方法选取2022年3月—2023年12月北京市第六医院收治的100例早期糖尿病肾病患者为研究对象,以随机数表法分为研究组和对照组,各50例。给予全部患者常规治疗,研究组加用达格列净治疗,对照组加用二甲双胍治疗,对比两组血糖水平、肾功能和不良反应发生情况。结果治疗后,研究组空腹血糖为(5.16±0.77)mmol/L,餐后2 h血糖为(7.11±1.38)mmol/L,糖化血红蛋白为(5.05±0.73)%,低于对照组,差异有统计学意义(t=4.592、5.020、5.093,P均<0.05)。治疗后,研究组尿白蛋白/肌酐比值、肾小球过滤率优于对照组,差异有统计学意义(P均<0.05)。研究组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论在早期糖尿病肾病治疗中采用SGLT-2抑制剂达格列净疗效显著,可以有效降低血糖水平,改善肾功能,降低不良反应发生率。

尿α1微球蛋白、尿β2微球蛋白、尿微量白蛋白/肌酐比联合检测在早期糖尿病肾病诊断中的意义

目的:尿α1微球蛋白(α1-MG)、尿β2微球蛋白(β2-MG)、尿微量白蛋白/肌酐比(ACR)联合检测在早期糖尿病肾病(EDN)诊断中的意义。方法:选取2022年11月—2023年12月在盐城市中医院住院的208例2型糖尿病患者作为研究对象,根据患者24 h尿蛋白定量水平(UAER),将单纯糖尿病(DM)组、EDN组和临床糖尿病肾病(DN)组患者作为研究组,另选取43例同期在盐城市中医院健康体检者为对照组。比较两组的尿α1-MG、β2-MG和ACR检测结果差异,比较研究组的尿α1-MG、β2-MG和ACR检测结果差异,绘制受试者工作曲线(ROC)分析3项指标单独及联合检测对糖尿病患者早期肾损伤(EKI)的诊断意义。结果:研究组的尿α1-MG、β2-MG和ACR水平均高于对照组,EDN组的尿α1-MG、β2-MG和ACR水平均明显高于较DM组,DN组的3项指标均较EDN组明显增高,差异有统计学意义(P<0.05);ROC曲线显示,尿α1-MG、β2-MG和ACR单独与联合检测预测2型糖尿病发生早期肾损伤的AUC分别为0.833、0.870、0.981、0.993,其中联合检测预测价值更高。结论:尿α1-MG、β2-MG和ACR联合检测在诊断EDN中具有较高的临床意义。

尿KIM-1、TG/Cys C和尿ACR在糖尿病早期肾损伤诊断中的应用价值

目的探讨尿肾损伤分子-1(KIM-1)、三酰甘油/胱抑素C(TG/Cys C)与尿微量白蛋白与尿肌酐比值(ACR)联合对糖尿病早期肾损伤患者的诊断价值,为避免临床延误诊断提供参考。方法将2020年1月至2023年12月收治的糖尿病早期肾损伤患者200例作为肾损伤组,按4∶1匹配原则选取糖尿病不伴肾损伤患者50例作为对照组。统计2组一般资料、尿KIM-1、TG/Cys C、尿ACR,分析肾损伤组尿KIM-1、TG/Cys C与尿ACR相关性;多因素logistic回归分析尿KIM-1、TG/Cys C对糖尿病早期肾损伤的影响,分析尿KIM-1、TG/Cys C、尿ACR对糖尿病早期肾损伤诊断价值。结果肾损伤组高血压病患者占比、糖化血红蛋白高于对照组,病程长于对照组(P<0.05,P<0.01);肾损伤组尿KIM-1、尿ACR高于对照组,TG/Cys C低于对照组(P<0.01);肾损伤组尿KIM-1与尿ACR呈正相关(r=0.749,P<0.001),TG/Cys C与尿ACR呈负相关(r=-0.693,P<0.001);尿KIM-1、TG/Cys C是糖尿病早期肾损伤的独立影响因素(P<0.01);尿KIM-1+TG/Cys C+尿ACR联合诊断糖尿病早期肾损伤的曲线下面积大于尿KIM-1+TG/Cys C、尿KIM-1+尿ACR、TG/Cys C+尿ACR。结论糖尿病早期肾损伤患者尿KIM-1、TG/Cys C与尿ACR密切相关,联合检测可明显提高糖尿病早期肾损伤的诊断效能。

益肾别浊丸对糖尿病早期肾病患者血清Periostin水平及尿ACR的影响

目的:观察益肾别浊丸对糖尿病早期肾病患者血清Periostin水平及尿ACR的影响。方法:将180例患者随机分为A、B、C三组,在给予基础治疗的同时,A组加益肾别浊丸10 g,3次/d,B组加缬沙坦胶囊80 mg,1次/d,C组患者加中药益肾别浊丸联合缬沙坦胶囊。于治疗前、治疗1个月及治疗3个月时记录3组患者中医证候积分及临床生化指标。结果:各组患者治疗3个月后较治疗前,症状积分、血脂、尿ACR及血清Periostin水平均有较为明显改善(P<0.05),其中A、C组患者在治疗1个月时部分症状、尿ACR及血清Periostin水平改善较B组更为明显(P<0.05)。结论:益肾别浊丸可改善糖尿病早期肾病临床症状,明显降低患者尿ACR及血清Periostin水平。

脂肪酸结合蛋白4在2型糖尿病肾病中的诊断价值

目的:探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清脂肪酸结合蛋白4(fatty acid-binding protein 4,FABP4)与糖尿病肾病(diabetic nephropathy,DN)的相关性及其作为DN早期诊断的应用价值。方法:纳入T2DM患者218例及健康体检者(对照组)20名,收集受试者的一般临床资料如身高、体质量、腰围、糖尿病病程等,计算BMI;收集血糖、糖化血红蛋白、空腹胰岛素、空腹C肽、肝肾功能、血脂等指标,计算稳态模型胰岛素抵抗指数(homeostasis model assessment-insulin resistance index,HOMA-IR)。采用ELISA测定血清FABP4水平;采用联合血肌酐(serum creatinine,Scr)和胱抑素C(cystatin C,Cys C)的慢性肾脏病流行病学协作方程式计算肾小球滤过率;测定尿白蛋白和肌酐水平,计算尿微量蛋白与肌酐比值(urinary albumin to creatinine ratio,UACR)。根据估算的肾小球滤过率(estimated glomerular filtration rate,eGFR)水平将T2DM患者分为肾功能正常组(eGFR≥90 mL/min/1.73 m^(2))、轻度肾功能不全组(eGFR 60~<90 mL/min/1.73 m^(2))和中度肾功能不全组(eGFR 30~<60 mL/min/1.73 m^(2));根据UACR水平分为正常蛋白尿组(UACR<30 mg/g)、微量蛋白尿组(UACR 30~<300 mg/g)和大量蛋白尿组(UACR≥300 mg/g)。采用回归分析评估FABP4与eGFR、UACR严重程度的相关性。结果:(1)与对照组相比,T2DM患者的血清FABP4显著升高。(2)在根据eGFR分层的3个亚组中,随着eGFR的下降,血清FABP4水平显著增加(P<0.001)。但在UACR亚组中差异无统计学意义(P=0.382)。(3)Spearman相关分析显示FABP4与eGFR呈负相关(r=-0.203,P=0.001),与UACR无相关性(r=0.130,P=0.055)。(4)多元线性回归表明,FABP4与eGFR呈独立负相关(r=-0.211,P<0.001),与UACR无相关性(r=-0.047,P=0.534)。(5)ROC曲线显示FABP4诊断DN的最佳截断值为103.9μg/L,AUC为0.745(灵敏度51.2%,特异度92.7%)。结论:T2DM患者血清FABP4水平升高与DN发生发展相关,有可能作为DN早期诊断的生物标志物。

达格列净治疗早期糖尿病肾病的临床效果研究

目的研究早期糖尿病肾病患者接受达格列净治疗的临床效果。方法选取2022年4月—2024年3月泰州市第二人民医院收治的76例早期糖尿病肾病患者为研究对象,按照治疗方法不同分为两组,各38例。研究组采用达格列净治疗,对照组采用二甲双胍治疗。比较两组血糖水平、肾功能、临床疗效。结果研究组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,研究组血尿素氮、血肌酐、尿微量白蛋白水平均低于对照组,差异有统计学意义(P均<0.05)。治疗后,研究组空腹血糖、餐后2 h血糖、糖化血红蛋白水平均低于对照组,差异有统计学意义(P均<0.05)。结论达格列净用于早期糖尿病肾病治疗中,可修复患者受损的肾功能,有效控制血糖,临床疗效较好。

依帕司他治疗早期2型糖尿病肾病临床观察

目的探讨依帕司他治疗早期2型糖尿病肾病的临床疗效。方法选取医院2021年5月至2023年5月收治的糖尿病肾病患者64例,随机分为对照组和观察组,各32例。两组患者均予常规综合治疗,观察组患者加服依帕司他片,两组均持续治疗12周。结果与对照组比较,观察组患者治疗后的糖化血红蛋白、空腹血糖、餐后2小时血糖水平均显著降低(P<0.05),尿量显著增加,尿蛋白和尿素氮水平均显著降低(P<0.05)。两组不良反应发生率无显著差异(P>0.05)。结论依帕司他治疗早期2型糖尿病肾病,能提高血糖控制效果,促进患者的肾功能恢复。

达格列净联合利格列汀治疗2型糖尿病合并早期糖尿病肾病的临床疗效研究

目的探讨达格列净联用利格列汀在2型糖尿病合并早期糖尿病肾病中的临床治疗效果。方法选取2021年4月—2023年4月新会区人民医院收治的76例2型糖尿病合并早期糖尿病肾病患者为研究对象,根据治疗方法的不同分为两组,观察组(39例)应用达格列净联合利格列汀治疗,对照组(37例)应用格列齐特缓释片+盐酸二甲双胍缓释片治疗,治疗3个月后比较两组患者的空腹血糖、糖化血红蛋白、血肌酐、24 h尿微量白蛋白、肾小球滤过率及不良反应发生情况。结果治疗后,两组空腹血糖及糖化血红蛋白水平均低于治疗前,差异有统计学意义(P均<0.05)。治疗后,对照组空腹血糖水平低于观察组,差异有统计学意义(P<0.05)。对照组治疗后24 h尿微量白蛋白、血肌酐及肾小球滤过率与治疗前比较,差异无统计学意义(P均>0.05);而观察组治疗后24 h尿微量白蛋白较治疗前减少,血肌酐较治疗前下降,肾小球滤过率较治疗前升高,差异有统计学意义(P均<0.05)。两组患者均未发生严重不良反应。结论达格列净联用利格列汀2型糖尿病合并早期糖尿病肾病的治疗中既能良好控制血糖,也能使尿蛋白减少、改善肾功能。

尿ACR、CN1在早期糖尿病肾病诊断中的价值

目的探讨尿ACR、CN1诊断早期糖尿病肾病(DN)的价值。方法选取90例DN患者为观察组,90例健康人为对照组,比较两组的尿ACR、CN1以及肾功能指标,分析尿ACR、CN1与DN患者肾功能指标的相关性以及对DN的诊断价值。结果观察组的尿ACR、CN1及血清Scr、BUN、AA、CysC水平高于对照组(P<0.05)。尿ACR、CN1与Scr、BUN、AA、Cys C均呈正相关(P<0.05)。尿ACR、CN1联合检测诊断DN的AUC高于ACR、CN1单独检测(P<0.05)。结论尿ACR、CN1在早期DN患者中表达升高并与患者肾功能指标存在相关性,联合检测二者可提高对早期DN的诊断价值。