达格列净联合雷公藤治疗糖尿病肾病临床效果观察  

Effects of dapagliflozin combined with tripterygium wilfordii on oxidative factor and proteinuria in diabetic nephropathy

作　　者：厉春萍[1] 徐光标[1] LI Chunping;XU Guangbiao(Department of Nephrology,Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University,Taizhou 317000,China)

机构地区：[1]浙江省台州医院肾内科,317000

出　　处：《浙江医学》2022年第12期1304-1308,共5页Zhejiang Medical Journal

基　　金：浙江省中医药科技计划项目(2021ZB331)。

摘　　要：目的分析达格列净联合雷公藤治疗糖尿病肾病的临床效果。方法回顾性分析2020年3月-2021年3月在浙江省台州医院收治的糖尿病肾病患者,以雷公藤多苷片治疗为对照组,以雷公藤多苷片加达格列净治疗为研究组,观测两组患者疗效和治疗前后FPG、收缩压、舒张压、免疫功能指标、氧化因子水平、蛋白尿水平、炎症因子水平,并作分析比较。结果与治疗前相比,治疗后研究组和对照组的FPG分别为(8.54±0.93)和(6.32±0.08)mmol/L;收缩压分别为(123.47±14.55)和(111.40±10.82)mmHg,舒张压分别为(80.47±9.56)和(72.44±8.32)mmHg;CD8^(+)细胞相对含量分别为(24.85±3.59)%和(19.84±2.54)%;丙二醛(MDA)浓度分别为(25.97±3.55)和(19.84±2.12)mmol/L,尿素氮分别为(7.12±0.73)和(6.25±0.69)mmol/L;24 h尿蛋白质量分别为(3.22±0.39)和(2.18±0.25)g;单核细胞趋化蛋白-1(MCP-1)质量浓度分别为(276.14±32.14)和(235.44±28.61)ng/L,IL-6分别为(9.87±0.22)和(7.21±0.85)ng/L,TNFα分别为(12.55±1.35)和(9.24±0.98)ng/L;研究组均高于对照组(均P<0.05)。CD4^(+)细胞相对含量分别为(42.81±5.01)%和(48.95±5.22)%,CD4^(+)/CD8^(+)分别为(1.85±0.21)和(2.74±0.35);超氧化物歧化酶(SOD)分别为(78.54±8.62)和(95.55±10.17)U/ml;对照组均高于研究组(均P<0.05)。相比对照组,研究组治疗前后变化幅度较大,具有统计学差异(P<0.05)。研究组治疗总有效率高于对照组(P<0.05)。结论达格列净联合雷公藤可降低糖尿病肾病患者炎症因子水平,改善患者免疫功能与氧化应激平衡,促进患者的肾病改善。Objective Analyze the therapeutic effects of dapagliflozin combined with tripterygium wilfordii(TW)on oxidative factors and proteinuria in diabetic nephropathy.Methods A retrospective analysis was performed on 80 patients with diabetic nephropathy treated in Taizhou Hospital,Zhejiang Province from March 2020 to March 2021.According to their treatment methods,they were divided into control group and study group,40 patients in each group received conventional treatment.The control group was treated with TW tablets,and the study group was given dapagliflozin on the basis of the TW.Fasting blood glucose,systolic blood pressure,diastolic blood pressure,immune function index,oxidative factor level,proteinuria level and inflammatory factor level were detected in both groups.Results Fasting plasma glucose were 8.54±0.93 and 6.32±0.08 mmol/L in the study and control groups,respectively,after treatment compared with before treatment.Systolic blood pressure were 123.47±14.55 and 111.40±10.82 mmHg(1 mmHg=0.133 kPa),and diastolic blood pressure were 80.47±9.56 and 72.44±8.32 mmHg,respectively.The relative content of CD8+cells were 24.85%±3.59%and 19.84%±2.54%,respectively.The concentrations of malondialdehyde(MDA)were 25.97±3.55 and 19.84±2.12 mmol/L,and urea nitrogen were 7.12±0.73 and 6.25±0.69 mmol/L,respectively.24-h urinary protein amounts were 3.22±0.39 and 2.18±0.25 g,respectively.The mass concentrations of monocyte chemoattractant protein-1(MCP-1)were 276.14±32.14 and 235.44±28.61 ng/L,IL-6 were 9.87±0.22 and 7.21±0.85 ng/L,and TNF-αwere 12.55±1.35 and 9.24±0.98 ng/L,respectively.Those are higher in the study group than in the control group.The relative contents of CD4+cells were 42.81%±5.01%and 48.95%±5.22%,and CD4+/CD8+were 1.85±0.21 and 2.74±0.35,respectively,78.54±8.62 and 95.55±10.17 U/ml for superoxide dismutase(SOD),respectively.Which are higher in the control group than in the study group.Compared with the control group,the study group had a larger variation of pre-and post-treatment

关 键 词：达格列净 雷公藤 糖尿病肾病 氧化因子 蛋白尿 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]