卡格列净对伴微量蛋白尿的T2DM患者血糖指标、炎症因子及肾功能的影响  

Effect of canagliflozin on blood glucose index,renal function,and inflammatory factors in T2DM patients with microalbuminuria

作　　者：唐小波[1] 谭丽玲[1] 周胃雯 林先珍 符丽娜 TANG Xiaobo;TAN Liling;ZHOU Weiwen;LIN Xianzhen;FU Lina(Health Management Center,First Affiliated Hospital of Hainan Medical University,Haikou 570102,China)

机构地区：[1]海南医学院第一附属医院健康管理中心,海口570102

出　　处：《临床与病理杂志》2023年第1期41-47,共7页Journal of Clinical and Pathological Research

基　　金：海南省医药卫生科研项目(20A200497)。

摘　　要：目的:探讨卡格列净对2型糖尿病(type 2 diabetes mellitus,T2DM)合并微量蛋白尿(microalbuminuria,MA)患者血糖、炎症因子及肾功能的影响。方法:选取2021年1月至2022年1月在海南医学院第一附属医院接受诊治的T2DM合并MA患者100例,并随机将其分为卡格列净组(n=50)与对照组(n=50)。2组均常规予以二甲双胍片口服,此外,卡格列净组予以卡格列净片(100 mg/次,1次/d),对照组予以格列美脲片(2~4 mg/次,1次/d);2组疗程均为3个月。治疗前后检测血糖指标[空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2 h postprandial blood glucose,2 hPBG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)]、血脂指标[总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)和低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)]、肾功能指标[血肌酐(serum creatinine,SCr)、半胱氨酸蛋白酶抑制剂C(cystatin C,Cys C)、血尿素氮(blood urea nitrogen,BUN)、尿白蛋白/肌酐比值(urinary albumin to creatinine ratio,UACR)、肾小球滤过率估计值(estimated glomerular filtration rate,eGFR)]及炎症因子[超敏C反应蛋白(highsensitivityC-reactiveprotein, hs-CRP)、肿瘤坏死因子-α(tumornecrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)]水平。结果:治疗后,2组FBG、2 hPBG、HbA1c和TC、TG、LDL-C均较治疗前明显降低(均P<0.05),2组间差异无统计学意义(均P>0.05)。治疗后,2组SCr、Cys C、BUN、UACR、 eGFR和hs-CRP、 TNF-α、 IL-6均较治疗前明显降低,且卡格列净组上述指指标均明显低于对照组(均P<0.05)。结论:卡格列净治疗T2DM合并MA患者可有效降低血糖,并对肾功能具有保护作用。Objective: To investigate the effects of canagliflozin on blood glucose, inflammatory factors, and renal function in patients with type 2 diabetes mellitus(T2DM) and microalbuminuria(MA).Methods: A total of 100 patients with T2DM combined with MA who were treated in the First Affiliated Hospital of Hainan Medical University from January 2021 to January 2022 were selected and randomly divided into a canagliflozin group(n=50) and a control group(n=50). Both groups were given metformin tablets orally, in addition, the canagliflozin group was given canagliflozin tablets(100 mg, once a day), and the control group was given glimepiride tablets(2-4 mg, once a day). Both groups were treated for 3 months. Before and after treatment, blood glucose indexes [fasting blood glucose(FBG), 2 h postprandial blood glucose(2 hPBG), glycosylated hemoglobin(HbA1c)], blood lipid indexes [total cholesterol(TC), triglyceride(TG), and low density lipoprotein cholesterol(LDL-C)], renal function indexes [serum creatinine(SCr), cystatin C(Cys C), blood urea nitrogen(BUN), urinary albumin to creatinine ratio(UACR), and estimated glomerular filtration rate(eGFR)], and inflammatory factors [high sensitivity C-reactive protein(hs-CRP), tumor necrosis factor-α(TNF-α), and interleukin-6(IL-6)] were measured.Results: After treatment, levels of FBG, 2 hPBG, HbA1c, TC, TG, and LDL-C in the 2 groups were lower than those before treatment(all P<0.05);there was no difference between the 2 groups(all P>0.05). After treatment, levels of SCr, Cys C, BUN, UACR, eGFR, hs-CRP, TNF-α, and IL-6 were lower than those before treatment(all P<0.05). After treatment, the levels of above indexes in the canagliflozin group were lower than those in the control group(all P<0.05).Conclusion: Canagliflozin can effectively reduce blood glucose and protect renal function in patients with T2DM combined with MA.

关 键 词：2型糖尿病 糖尿病肾病 蛋白尿 卡格列净 肾功能 

分 类 号：R696.2[医药卫生—泌尿科学] R587.2[医药卫生—外科学]