卡格列净联合厄贝沙坦治疗早期糖尿病肾病的临床效果  

Clinical effect of canagliflozin combined with irbesartan in the treatment of early diabetic nephropathy

作　　者：邢建东[1] 姚艳琴[2] 王静茹 马春明[1] 陈海丽[1] XING Jiandong;YAO Yanqin;WANG Jingru;MA Chunming;CHEN Haili(Department of Endocrinology,Datong Fifth People′s Hospital,Datong 037000,Shanxi,China;Department of Imaging,Datong Fifth People′s Hospital,Datong 037000,Shanxi,China)

机构地区：[1]大同市第五人民医院内分泌科,山西省大同市037000 [2]大同市第五人民医院影像科,山西省大同市037000

出　　处：《广西医学》2023年第6期634-638,共5页Guangxi Medical Journal

基　　金：山西省大同市重点研究计划项目(2018082)。

摘　　要：目的探讨卡格列净联合厄贝沙坦治疗早期糖尿病肾病患者的临床效果。方法选取100例早期糖尿病肾病患者,随机分为对照组和研究组,每组50例。在常规治疗基础上,给予对照组患者厄贝沙坦治疗,给予研究组患者厄贝沙坦联合卡格列净治疗,两组患者均治疗30 d。比较两组患者治疗前后尿蛋白指标(24 h尿蛋白定量水平、尿微量白蛋白排泄率)、肾功能指标(血清肌酐水平、肌酐清除率)、氧化应激指标水平(8-羟基脱氧鸟嘌呤、丙二醛)、血脂水平(三酰甘油、总胆固醇),以及治疗期间不良反应发生率。结果治疗后,两组24 h尿蛋白定量水平、尿微量白蛋白排泄率、血清肌酐水平、血清8-羟基脱氧鸟嘌呤和丙二醛水平、三酰甘油和总胆固醇水平均低于治疗前,肌酐清除率均高于治疗前,且研究组的上述指标均优于对照组(均P<0.05)。两组患者治疗期间不良反应发生率比较差异无统计学意义(P>0.05)。结论与单用厄贝沙坦相比,卡格列净联合厄贝沙坦可以更好地改善早期糖尿病患者尿蛋白水平和肾功能,减轻氧化应激反应,降低血脂水平。Objective To explore the clinical effect of canagliflozin combined with irbesartan in the treatment of patients with early diabetic nephropathy.Methods A total of 100 patients with early diabetic nephropathy were selected,and they were randomly divided into control group or study group,with 50 cases in each group.On the basis of routine therapy,the control group was treated with irbesartan,and the study group was treated with irbesartan combined with canagliflozin.Both groups received a 30-day treatment.The pre-and post-treatment urinary protein indices with respect to 24-hour urinary protein quantitation level and urinary microalbumin excretion rate,renal function indicators in terms of serum creatinine level and creatinine clearance rate,oxidative stress indicators levels(8-hydroxydeoxyguanosine and malondialdehyde),and blood lipid levels in terms of triglyceride and total cholesterol,as well as the incidence rate of adverse reactions during treatment in patients were compared between the two groups.Results After treatment,24-hour urinary protein quantitation level,urinary microalbumin excretion rate,and levels of serum creatinine,8-hydroxydeoxyguanosine,malondialdehyde,as well as levels of triglyceride and total cholesterol in the two groups were lower than those before treatment,whereas creatinine clearance rate in the two groups was higher than that before treatment,and the aforementioned indices were superior in the study group to in the control group(all P<0.05).No statistically significant difference in the incidence rate of adverse reactions during treatment was found between the two groups(P>0.05).Conclusion Compared with the application of irbesartan alone,canagliflozin combined with irbesartan can preferably ameliorate urinary protein level and renal function in patients with early diabetic nephropathy,relieve their oxidative stress responses,and decrease blood lipid level.

关 键 词：早期糖尿病肾病 卡格列净 厄贝沙坦 尿蛋白 肾功能 氧化应激 血脂 

分 类 号：R749.9[医药卫生—神经病学与精神病学]