卡格列净联合胰激肽原酶肠溶片治疗糖尿病肾病的效果  

Effect of canagliflozin combined with pancreatic kininogenase enteric-coated tablets on diabetic nephropathy

作　　者：刘海霞[1] 褚夫宝[1] 刘文花[1] 滕燕民[1] 王春花[1] Liu Haixia;Chu Fubao;Liu Wenhua;Teng Yanmin;Wang Chunhua(Department of Nephrology,Qinghai Provincial People's Hospital,Xining 810000,China)

机构地区：[1]青海省人民医院肾内科,西宁810000

出　　处：《中国医药》2022年第7期1015-1019,共5页China Medicine

基　　金：青海省卫生健康系统指导性计划课题(2019-wjzdx-33)。

摘　　要：目的探讨卡格列净联合胰激肽原酶肠溶片治疗糖尿病肾病的效果。方法选取青海省人民医院2018年6月至2020年12月收治的糖尿病肾病患者91例,应用随机数字表法分为对照组(45例)与观察组(46例)。对照组在常规干预基础上给予卡格列净片治疗,观察组在对照组治疗基础上联合胰激肽原酶肠溶片治疗,2组均治疗16周。比较2组治疗前后糖代谢、肾功能、免疫功能和氧化应激指标水平以及临床疗效。结果治疗后,2组空腹血糖、餐后2 h血糖、糖化血红蛋白、血尿素氮、血肌酐、尿白蛋白排泄率、CD_(8)^(+)、8-羟基脱氧鸟嘌呤和活性氧水平均低于治疗前且观察组均低于对照组[(6.0±0.3)mmol/L比(7.0±1.6)mmol/L、(7.6±1.0)mmol/L比(8.4±1.1)mmol/L、(6.2±0.5)%比(8.0±0.7)%、(5.1±1.3)mmol/L比(8.6±1.1)mmol/L、(81±8)μmol/L比(110±11)μmol/L、(79±8)μg/min比(113±11)μg/min、(21±4)%比(27±5)%、(2.6±0.4)μg/L比(3.0±0.4)μg/L、(357±39)kU/L比(431±38)kU/L],CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)比值、丙二醛水平均高于治疗前且观察组均高于对照组[(39±8)%比(34±6)%、(1.85±0.41)比(1.24±0.17)、(35.4±2.2)mmol/L比(29.6±2.4)mmol/L](均P<0.05)。治疗16周后,观察组总有效率高于对照组[93.5%(43/46)比68.9%(31/45)](P=0.003)。结论卡格列净联合胰激肽原酶肠溶片治疗糖尿病肾病能够进一步降低血糖,提高机体免疫功能,减轻氧化应激反应,改善肾功能,提高疗效。Objective To explore the effect of canagliflozin combined with pancreatic kininogenase enteric-coated tablets on diabetic nephropathy.Methods A total of 91 patients admitted to Qinghai Provincial People′s Hospital from June 2018 to December 2020 were enrolled.Patients were randomly divided into control group(45 cases)and observation group(46 cases).The control group was treated with canagliflozin tablets on the basis of routine intervention.The observation group was treated with pancreatic kininogenase enteric-coated tablets on the basis of the control group.Both groups were treated for 16 weeks.The levels of glycometabolism,renal function,immune function,oxidative stress and clinical effect were compared between the two groups.Results After treatment,the levels of fasting blood glucose,2 h postprandial blood glucose,glycosylated hemoglobin,blood urea nitrogen,serum creatinine,urinary albumin excretion rate,CD_(8)^(+),8-hydroxydeoxyguanine and reactive oxygen species in both groups were lower than those before treatment and the levels in the observation group was lower than those in the control group[(6.0±0.3)mmol/L vs(7.0±1.6)mmol/L,(7.6±1.0)mmol/L vs(8.4±1.1)mmol/L,(6.2±0.5)%vs(8.0±0.7)%,(5.1±1.3)mmol/L vs(8.6±1.1)mmol/L,(81±8)μmol/L vs(110±11)μmol/L,(79±8)μg/min vs(113±11)μg/min,(21±4)%vs(27±5)%,(2.6±0.4)μg/L vs(3.0±0.4)μg/L,(357±39)kU/L vs(431±38)kU/L];the levels of CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+) and malondialdehyde in both groups were higher than those before treatment and the levels in the observation group were higher than those in the control group[(39±8)%vs(34±6)%,(1.85±0.41)vs(1.24±0.17),(35.4±2.2)mmol/L vs(29.6±2.4)mmol/L](all P<0.05).After 16 weeks of treatment,the total effective rate in the observation group was higher than that in the control group[93.5%(43/46)vs 68.9%(31/45)](P=0.003).Conclusions The combination of canagliflozin and pancreatic kininogenase enteric-coated tablets can further reduce blood glucose,improve immune function,reduce oxidative stress,and i

关 键 词：糖尿病肾病 卡格列净 胰激肽原酶肠溶片 肾功能 免疫功能 

分 类 号：R587.2[医药卫生—内分泌]