SGLT2抑制剂联合二甲双胍治疗早期糖尿病肾病的疗效及安全性  

Efficacy and Safety of SGLT2 Inhibitor combined with Metformin in the Treatment of Early Diabetic Nephropathy

作　　者：黄岩 王华敏 HUANG Yan;WANG Huamin(Department of Nephrology,Huairou Hospital,Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 101499,China)

机构地区：[1]首都医科大学附属北京朝阳医院怀柔医院肾内科,北京101499

出　　处：《中国医药指南》2022年第14期1-4,共4页Guide of China Medicine

摘　　要：目的探讨钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂卡格列净(CANA)联合二甲双胍(MET)在治疗早期糖尿病肾病(DKD)中的临床效果。方法选取2019年3月至2021年5月在我院接诊的106例DKD早期患者,按随机数字表法分为对照组(n=53)和观察组(n=53)。根据治疗方案不同分为观察组及对照组,对照组单用MET治疗,观察组在此基础上联合CANA 100 mg每日1次治疗。连续用药6个月后,检测糖红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2hPG)、三酰甘油(TG)、低密度脂蛋白(LDL-C)、血尿酸(UA),并比较两组不良事件(泌尿系感染、低血糖)的发生率。结果两组治疗后SBP、DBP、BMI均低于治疗前,观察组治疗后的SBP、DBP、BMI低于对照组,两组治疗后的HbA1c、FPG、2hPG均低于治疗前,观察组治疗后的HbA1c、FPG、2hPG低于对照组,两组治疗后TG、UA均低于治疗前,差异有统计学意义(P<0.05)。两组患者治疗后LDL-C比较差异无统计学意义(P>0.05)。治疗后,观察组发生低血糖7.55%(4/53),泌尿系感染5.66%(3/53),对照组低血糖发生率1.89%(1/53),泌尿系感染发生率3.77%(2/53),两组差异无统计学意义(P>0.05)。结论CANA联合MET治疗早期DKD,能够有效的控制血糖,降低血压、降低体质量,且安全性高。Objective To investigate the effect of CANA combined with metformin(MET)in the treatment of early diabetic kidney disease(DKD)clinical effect.Methods A total of 106 patients with early DKD treated in our hospital from March 2019 to May 2021 were selected and divided into control group(n=53)and observation group(n=53)according to random number table.The control group was treated with MET alone,and the observation group was additionally given a dose of CANA 100 mg once a day.After 6 months of continuous medication,the incidence of adverse events(urinary tract infection,hypoglycemia)was compared between the two groups,and the levels of HbA1c,FPG,2hPG,TG,LDL-C and UA were determined.Results After treatment,SBP,DBP and BMI of the two groups were lower than before;after treatment,SBP,DBP and BMI of the observation group were lower than the control group;after treatment,HbA1c,FPG and 2hPG of the observation group were lower than the control group;after treatment,TG and UA of the two groups were lower than before,the difference was statistically significant(P<0.05).There was no significant difference in LDL-C between 2 groups after treatment(P>0.05).After treatment,7.55%(4/53)of hypoglycemia and 5.66%(3/53)of urinary tract infection occurred in the observation group,while 1.89%(1/53)of hypoglycemia and 3.77%(2/53)of urinary tract infection occurred in the control group,and there was no statistical significance between the two groups(P>0.05).Conclusion CANA combined with MET in the treatment of early DKD can effectively control blood glucose,reduce blood pressure and body weight with high safety.

关 键 词：糖尿病肾病 钠-葡萄糖协同转运蛋白2抑制剂 卡格列净 二甲双胍 

分 类 号：R587.2[医药卫生—内分泌]