摘要
目的探讨糖尿病肾病(diabetic kidney disease, DKD)患者接受钠-葡萄糖协同转运蛋白2(sodium/glucose cotransportor 2, SGLT2)抑制剂达格列净治疗的效果及其对肾功能、中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipocalin, NGAL)、单核细胞趋化蛋白-1(monocyte chemoattractant protein-1, MCP-1)的影响。方法纳入2018年10月~2019年10月期间我院治疗的113例DKD患者作为观察对象, 掷币法将其分成两组, 均接受糖尿病健康教育、饮食、控制血糖等基础治疗。对照组56例在常规治疗的基础上加用厄贝沙坦治疗, 观察组57例在对照组治疗的基础上加以达格列净治疗。比较两组患者的治疗效果、肾功能指标、促炎性因子水平。结果治疗后, 两组患者尿微量白蛋白与肌酐比值(urinary albumin excretion rate, UACR)、估算肾小球滤过率(estimated glomerular filtration rate, eGFR)以及尿白蛋白排泄率(urinary albumin excretion rate, UAER)均明显降低, 且观察组低于对照组(P<0.05);两组患者NGAL、MCP-1、白细胞介素-6(interleukin-6, IL-6)以及肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)均明显降低, 且观察组患者低于对照组(P<0.05)。两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论达格列净联合厄贝沙坦能显著降低DKD患者促炎性因子水平, 减少蛋白尿产生, 减轻患者肾脏炎性损伤, 延缓DKD疾病进展, 值得推荐。
Objective To explore the treatment effect of the sodium/glucose cotransporter 2(SGLT2)inhibitor dapagliflozin on patients with diabetic kidney disease(DKD)and its influence on renal function,neutrophil gelatinase-associated lipocalin(NGAL)and monocyte chemoattractant protein-1(MCP-1).Methods A total of 113 patients with DKD treated in our hospital from October 2018 to October 2019 were recruited as observation objects.The patients were divided into 2 groups by tossing of coins method.Both groups received basic treatments such as diabetes health education,and diet and sugar control.Fifty-Six cases in the control group were treated with irbesartan on the basis of conventional treatment,and 57 cases in the observation group were treated with dapagliflozin on the basis of the treatment in the control group.The treatment effects,renal functions,and levels of pro-inflammatory factors were compared between the two groups.Results After the treatment,the urinary albumin creatinine ratio(UACR),estimated glomerular filtration rate(eGFR),and urinary albumin excretion rate(UAER)of the two groups were significantly reduced,and all above in the observation group were lower than those o f the control group(P<0.05).NGAL,MCP-1,interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were significantly reduced in the two groups,and all above in the observation group was lower than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions In patients with DKD,dapagliflozin combined with irbesartan can significantly reduce the levels of pro-inflammatory factors and the production of proteinuria,reduce the renal inflammatory damage,and delay the progression of disease.
作者
张亮
袁晓龙
王天笑
Zhang Liang;Yuan Xiaolong;Wang Tianxiao(Department of Pharmacy,Hebi People’s Hospital,Hebi 458030,China)
出处
《国际移植与血液净化杂志》
2022年第1期5-8,共4页
International Journal of Transplantation and Hemopurification
作者简介
通信作者:张亮,Email:zhanglianghxr@163.com。
