达格列净联合前列地尔治疗糖尿病肾病的效果及对患者肾脏微循环的影响  

The Effect of Dapagliflozin Combined with Alprostadil in the Treatment of Diabetic Nephropathy and Its Influence on Renal Microcirculation

作　　者：王丽 陈亚琳[2] WANG Li;CHEN Yalin(Department of Endocrinology and Geriatrics,Henan Chest Hospital,Zhengzhou Henan 450000,China;Department of Endocrinology,The First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou Henan 450000,China)

机构地区：[1]河南省胸科医院内分泌与老年病科,河南郑州450000 [2]河南中医药大学第一附属医院内分泌科二区,河南郑州450000

出　　处：《临床研究》2022年第7期87-90,共4页Clinical Research

摘　　要：目的探究达格列净+前列地尔对糖尿病肾病的效果及对肾脏微循环影响。方法对河南省胸科医院2018年1月至2020年11月选取的120例糖尿病肾病患者随机分组,对照组、观察组各60例。对照组予以达格列净治疗,观察组加以前列地尔治疗,比较两组的肾功能水平、血糖水平、不良反应发生率、尿蛋白及血糖改善时间、内皮素-1、血管性血友病因子、血管内皮生长因子水平。结果与对照组相比,观察组治疗有效率更高,治疗后,24 h尿蛋白、血肌酐、尿氮素等肾功能指标水平、血糖水平更低,差异有统计学意义(P<0.05)。对照组、观察组不良反应发生率组间比较,差异无统计学意义(P>0.05)。治疗后,相较于对照组来说,观察组患者的尿蛋白改善时间、血糖改善时间更短,差异有统计学意义(P<0.05)。治疗后,同对照组相比,观察组内皮素-1、血管性血友病因子、血管内皮生长因子水平更低,差异有统计学意义(P<0.05)。结论对糖尿病肾病患者在达格列净治疗基础上加以前列地尔治疗,能显著增强治疗效果,改善肾脏微循环与血糖水平,安全性亦较高,且可以更好地保护肾脏血管内皮,值得临床应用。Objective To explore the effect of dapagliflozin combined with alprostadil on diabetic nephropathy and its effect on renal microcirculation.Methods A total of 120 patients with diabetic nephropathy admitted to Henan Chest Hospital from January 2018 to November 2020 were randomly divided into control group(n=60)and observation group(n=60).The control group was treated with dagaglizin,and the observation group was treated with alprostadil.The renal function level,blood glucose level,incidence of adverse reactions,urinary protein and blood glucose improvement time,endothelin-1,von willebrand factor and vascular endothelial growth factor levels were compared between the two groups.Results Compared with the control group,the effective rate of treatment was higher in the observation group,and the 24 h urinary protein,serum creatinine,urinary nitrogen and other renal function indexes and blood glucose levels were lower after treatment,with statistically significant differences(P<0.05),but there was no statistically significant difference in the incidence of adverse reactions between the control group and observation group(P>0.05).After treatment,compared with the control group,the improvement time of urinary protein and blood glucose in observation group was shorter,and the difference was statistically significant(P<0.05).After treatment,compared with the control group,the levels of endothelin-1,von willebrand factor and vascular endothelial growth factor in the observation group were lower,the differences were statistically significant(P<0.05).Conclusion For patients with diabetic nephropathy,dapagliflozin plus alprostadil treatment can significantly enhance the therapeutic effect,improve renal microcirculation and blood glucose levels,and has high safety,and can better protect renal vascular endothelium,which is worthy of clinical application.

关 键 词：糖尿病肾病 达格列净 前列地尔 联合治疗 肾脏微循环 

分 类 号：R587.2[医药卫生—内分泌]