厄贝沙坦联合达格列净治疗糖尿病肾病伴大量蛋白尿的临床效果  

Clinical efficacy of irbesartan combined with dapagliflozin in the treatment of patients with diabetic nephropathy and macroalbuminuria

作　　者：朱吟冰 周燕[1] 喻敏[1] 李渊 刘春雅[1] ZHU Yinbing;ZHOU Yan;YU Min(Department of Nephrology,Quzhou People's Hospital,Quzhou 324000,CHINA)

机构地区：[1]衢州市人民医院肾内科,浙江324000 [2]衢州市第二人民医院全科医学科

出　　处：《江苏医药》2023年第7期689-692,共4页Jiangsu Medical Journal

摘　　要：目的探讨厄贝沙坦联合钠-葡萄糖共转运蛋白2抑制剂达格列净治疗糖尿病肾病伴大量蛋白尿患者的临床效果。方法将80例糖尿病肾病伴大量蛋白尿患者随机均分为观察组和对照组。在常规治疗基础上,对照组口服厄贝沙坦150mg,观察组口服达格列净10mg和厄贝沙坦150mg。采用乳胶增强免疫透射比浊法检测24-h尿蛋白和血清胱抑素C(CysC)水平,全自动生化分析仪检测血清白蛋白(Alb)、SCr和BUN水平,酶循环法检测同型半胱氨酸(Hcy)水平,记录两组临床治疗总有效率以及不良反应发生情况。结果与治疗前相比,两组治疗后24-h尿蛋白、SCr、BUN、CysC和Hcy水平降低,Alb水平升高(P<0.05),并且观察组变化更加明显(P<0.05)。观察组临床治疗总有效率高于对照组(92.5%vs.75.0%)(P<0.05)。观察组与对照组不良反应总发生率比较无统计学差异(15.0%vs.10.0%)(P>0.05)。结论厄贝沙坦联合达格列净治疗糖尿病肾病伴大量蛋白尿患者的临床效果显著,能有效降低24-h尿蛋白水平,改善肾功能,延缓疾病进展,且安全性较高。Objective To investigate the clinical effect of irbesartan combined with sodium-glucose cotransporter 2 inhibitor dapagliflozin in the treatment of the patients with diabetic nephropathy and macroalbuminuria.Methods Eighty patients with diabetic nephropathy and macroalbuminuria were randomly divided into two groups of A and B with 40 cases each.On the basis of conventional therapy,the patients in group A were orally administrated with irbesartan 150 mg,and those in group B were orally administrated with dapagliflozin 10 mg and irbesartan 150 mg.The levels of 24-hour urinary protein and cystatin C(CysC)were determined by latex-enhanced immunoturbidimetry.The levels of albumin(Alb),SCr and BUN were measured by full-automatic biochemical analyzer.The level of homocysteine(Hcy)was detected by enzymatic cycling assay.The total effectiveness rate of clinical treatment and adverse responses after treatment were observed in both groups.Results Compared with before,the levels of 24-hour urinary protein,SCr,BUN,CysC and Hcy were decreased,and the level of Alb was increased in both groups after treatment(P<0.05),which were changed more obviously in group B(P<0.05).The total effectiveness rate of clinical treatment in group B was higher than that in group A(92.5%vs.75.0%)(P<0.05).There was no statistical difference in the incidence of adverse responses between groups of B and A(15.0%vs.10.0%)(P>0.05).Conclusion Irbesartan combined with dapagliflozin has an obvious clinical efficacy in the treatment of the patients with diabetic nephropathy and macroalbuminuria,which can reduce level of 24-hour urinary protein,improve renal function,and delay disease progression with a higher safety.

关 键 词：厄贝沙坦 达格列净 糖尿病肾病 蛋白尿 

分 类 号：R587[医药卫生—内分泌]