卡格列净对2型糖尿病合并糖尿病肾病患者肾功能及不良事件的影响  

Effect of Canagliflozin on Renal Function and Adverse Events in Type 2 Diabetes Patients with Diabetes Nephropathy

作　　者：李恩就[1] 胡菂菂[1] 伍彬彬 李健芬 文婧怡 LI Enjiu;HU Didi;WU Binbin;LI Jianfen;WEN Jingyi(Jiangmen Central Hospital,Guangdong Province,Jiangmen 529000,China;不详)

机构地区：[1]广东省江门市中心医院,广东江门529000

出　　处：《中国医学创新》2023年第14期10-15,共6页Medical Innovation of China

基　　金：广东省江门市科技计划项目(2021YL01056)。

摘　　要：目的:观察卡格列净应用于2型糖尿病(T2DM)合并糖尿病肾病(DN)的疗效及对肾功能及不良事件的影响。方法:选取江门市中心医院2020年11月-2022年2月收治的T2DM合并DN患者100例,按照电脑数字表随机抽取法,平均分成治疗组和对照组,各50例,两组接受常规胰岛素强化治疗后,对照组予以西格列汀治疗,治疗组予以卡格列净治疗,观察对比两组治疗前和治疗3、6个月后血糖、胰岛素功能、脂代谢、尿常规及肾功能指标的变化。结果:两组治疗3、6个月各项血糖监测指标组间比较差异均无统计学意义(P>0.05);治疗组治疗3、6个月各项胰岛素功能、脂代谢指标均优于对照组(P<0.05),治疗组治疗3、6个月尿常规、肾功能检测指标均优于对照组(P<0.05);治疗组治疗3、6个月不良事件发生率均显著低于对照组(P<0.05)。结论:卡格列净应用于T2DM合并DN治疗中,降糖效果与西格列汀相当,但在提高胰岛素敏感性、降低胰岛素抵抗、改善脂代谢、保护肾功能和减少不良事件等方面,更占据优势。Objective:To observe the efficacy of Canagliflozin in type 2 diabetes(T2DM)with diabetes nephropathy(DN)and and its influence on renal function and adverse events.Method:A total of 100 patients with T2DM and DN admitted in Jiangmen Central Hospital from November 2020 to February 2022 were randomly divided into the treatment group and the control group according to the computer numerical table,with 50 patients in each group.After receiving conventional intensive insulin treatment,the control group was treated with Sitagliptin,and the treatment group was treated with Canagliflozin.Changes of blood glucose,insulin function,lipid metabolism,urine routine and renal function indexes in two groups before treatment and after 3 and 6 months of treatment were compared.Result:There were no significant differences in blood glucose monitoring indexes between the two groups after 3 and 6 months of treatment(P>0.05).The insulin function and lipid metabolism indexes in the treatment group after 3 and 6 months of treatment were significantly better than those in the control group,the differences were statistically significant(P<0.05).The urine routine and renal function test indexes of the treatment group at 3 and 6 months after treatment were were significantly better than those in the control group(P<0.05).The incidences of adverse events in the treatment group after 3 and 6 months of treatment were significantly lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:The hypoglycemic effect of Canagliflozin in the treatment of T2DM combined with DN is equivalent to that of Sitagliptin.However,it has advantages in improving insulin sensitivity,reducing insulin resistance,improving lipid metabolism,protecting renal function,and reducing adverse events.

关 键 词：卡格列净 2型糖尿病 糖尿病肾病 心血管事件 肾脏结局 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]