钠-葡萄糖协同转运蛋白2抑制剂治疗2型糖尿病患者的临床效果研究  

Clinical effect of sodium-glucose cotransporter 2 inhibitor in the treatment of patients with type 2 diabetes mellitus

作　　者：董亚苒 王新芳 佘其美 刘改芬[2] DONG Ya-ran;WANG Xin-fang;SHE Qi-mei(General Medical Department,Shijingshan Teaching Hospital of Capital Medical University,Beijing 100040,China)

机构地区：[1]首都医科大学石景山教学医院全科医学科,100040 [2]首都医科大学附属北京天坛医院,100050

出　　处：《中国实用医药》2022年第12期13-16,共4页China Practical Medicine

摘　　要：目的评估钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂治疗2型糖尿病患者对其血尿酸(UA)及电解质等水平的影响。方法39例2型糖尿病患者,均在原降糖方案的基础上加用达格列净治疗,并测定比较患者治疗前后的体重、腰围、体质量指数(BMI)、血压[收缩压(SBP)、舒张压(DBP)]、UA、电解质[血清钾(K)、血清钠(Na)、血清氯(Cl)]、空腹血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、糖化白蛋白(GA)、糖化血红蛋白(HbA1c)、C反应蛋白(CRP)、血红蛋白(HGB)、红细胞压积(HCT)水平。结果39例2型糖尿病患者年龄(51.3±9.1)岁,糖尿病病程中位数为6(3,14)年。治疗后12周,患者体重(78.36±5.55)kg、BMI(26.01±3.74)kg/m^(2)、UA(291.13±61.61)μmol/L、GA(17.62±3.34)%、HbA1c(6.97±0.60)%均低于治疗前的(81.86±5.62)kg、(28.35±4.76)kg/m^(2)、(322.50±63.28)μmol/L、(20.12±5.49)%、(7.98±1.43)%,Cl(102.58±2.93)mmol/L、HGB(153.30±14.65)g/L、HCT(45.19±3.77)%高于治疗前的(100.45±3.24)mmol/L、(144.23±14.22)g/L、(42.35±3.88)%;治疗后24周,患者体重(75.33±5.01)kg、BMI(23.66±3.99)kg/m2均低于治疗前和治疗后12周,腰围(98.35±4.20)cm低于治疗前的(101.31±5.01)cm以及治疗后12周的(100.68±4.75)cm、Cl(103.23±3.79)mmol/L高于治疗前的(100.45±3.24)mmol/L,GA(17.52±3.69)%、HbA1c(7.02±0.70)%均低于治疗前的(20.12±5.49)、(7.98±1.43)%,HCT(43.42±3.36)%低于治疗后12周的(45.19±3.77)%,差异均具有统计学意义(P<0.05)。SBP、DBP、K、Na、FBG、TG、TC、HDL-C、LDL-C、CRP、HGB水平与治疗前、治疗后12周比较,差异均无统计学意义(P>0.05)。治疗前-治疗后12周-治疗后24周时患者体重、腰围、BMI呈线性下降趋势(P<0.05);HbA1c(一次曲线:P<0.05;二次曲线:P<0.05)、GA(一次曲线:P<0.05;二次曲线:P<0.05)呈多阶曲线趋势,治疗前-治疗后12周疗程下降速度较快,治疗后12周-治疗后24周疗程下降速度缓�Objective To evaluate the effect of sodium-glucose cotransporter 2(SGLT2)inhibitors on serum uric acid(UA)and electrolyte levels in patients with type 2 diabetes mellitus.Methods All 39 patients with type 2 diabetes mellitus were treated with dapagliflozin on the basis of the original hypoglycemic regimen.The body weight,waist circumference,body mass index(BMI),blood pressure[systolic blood pressure(SBP),diastolic blood pressure(DBP)],UA,electrolytes[serum potassium(K),serum sodium(Na),serum chloride(Cl)],fasting blood glucose(FBG),triglycerides(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),glycated albumin(GA),glycosylated hemoglobin(HbA1c),C-reactive protein(CRP),hemoglobin(HGB),hematocrit(HCT)before and after treatment.Results 39 patients with type 2 diabetes mellitus aged(51.3±9.1)years,and the median duration of diabetes was 6(3,14)years.At 12 weeks after treatment,the body weight(78.36±5.55)kg,BMI(26.01±3.74)kg/m2,UA(291.13±61.61)μmol/L,GA(17.62±3.34)%,HbA1c(6.97±0.60)%were lower than(81.86±5.62)kg,(28.35±4.76)kg/m2,(322.50±63.28)μmol/L,(20.12±5.49)%,(7.98±1.43)%before treatment,and the Cl(102.58±2.93)mmol/L,HGB(153.30±14.65)g/L,HCT(45.19±3.77)%were higher than(100.45±3.24)mmol/L,(144.23±14.22)g/L,(42.35±3.88)%before treatment.At 24 weeks after treatment,the body weight(75.33±5.01)kg,BMI(23.66±3.99)kg/m2 were lower than those before treatment and at 12 weeks after treatment;the waist circumference(98.35±4.20)cm was lower than(101.31±5.01)cm before treatment and(100.68±4.75)cm at 12 weeks after treatment;the Cl(103.23±3.79)mmol/L was higher than(100.45±3.24)mmol/L before treatment;the GA(17.52±3.69)%and HbA1c(7.02±0.70)%were lower than(20.12±5.49)and(7.98±1.43)%before treatment;the HCT(43.42±3.36)%was lower than(45.19±3.77)%at 12 weeks after treatment;all the differences were statistically significant(P<0.05).There was no statistically significant difference in the levels of SBP,DBP,K,Na,FBG,TG,TC,HDL-C,LDL-C,C

关 键 词：钠-葡萄糖协同转运蛋白2抑制剂 达格列净 糖尿病 血尿酸 电解质 

分 类 号：R587.1[医药卫生—内分泌]