卡格列净联合缬沙坦治疗早中期糖尿病肾病的临床效果与安全性  

Clinical effect and safety of canagliflozin combined with valsartan in the treatment of early and mid-term diabetic kidney disease

作　　者：李山河[1] 戴秀娟[2] LI Shanhe;DAI Xiujuan(Department of Pharmacy,Zhangzhou Traditional Chinese Medical Hospital,Fujian Province,Zhangzhou 363000,China;不详)

机构地区：[1]福建省漳州市中医院药学部,363000 [2]福建省漳州市中医院糖肾科,363000

出　　处：《临床合理用药杂志》2023年第26期29-32,共4页Chinese Journal of Clinical Rational Drug Use

基　　金：福建中医药大学2020年校管课题临床专项(XB2020087)。

摘　　要：目的观察卡格列净联合缬沙坦治疗早中期糖尿病肾病(DKD)的临床效果与安全性。方法选取2020年8月—2022年4月漳州市中医院收治的早中期DKD患者60例,采用随机数字表法分为观察组和对照组,各30例。在常规治疗基础上,对照组予缬沙坦胶囊治疗,观察组在对照组基础上加用卡格列净片治疗,2组均连续治疗3个月。比较2组治疗效果,治疗前后肾功能指标[尿素氮(BUN)、血肌酐(SCr)、胱抑素C(CysC)、肾小球滤过率(eGFR)]、尿蛋白指标[尿微量白蛋白肌酐比(ACR)、24 h尿蛋白定量(UTP)]、血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA 1c)]、血脂指标[总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、超敏C反应蛋白(hs-CRP)水平,以及不良反应发生情况。结果观察组治疗总有效率为96.67%,高于对照组的70.00%(χ^(2)=7.680,P=0.006)。治疗3个月后,2组BUN、SCr、CysC、24 hUTP、ACR、FPG、2 hPG、HbA 1c、TC、TG、LDL-C、hs-CRP水平均较治疗前降低,eGFR与HDL-C水平较治疗前升高,且观察组降低或升高的程度大于对照组(P<0.05或P<0.01);观察组与对照组不良反应总发生率(6.67%vs.3.33%)比较差异无统计学意义(P>0.05)。结论卡格列净联合缬沙坦治疗早中期DKD的临床效果肯定,对肾脏保护具有协同作用,能有效控制血糖水平,抑制机体炎性反应及氧化应激反应,降低尿蛋白,改善患者肾功能,促进脂代谢,且用药安全性较高。Objective To observe the clinical effect and safety of canagliflozin combined with valsartan in the treatment of early and mid-term diabetic kidney disease(DKD).Methods Sixty early and mid-term DKD patients admitted to Zhangzhou Traditional Chinese Medical Hospital from August 2020 to April 2022 were selected.Divide into an observation group and a control group using a random number table method,with 30 cases in each group.On the basis of routine treatment,the control group was treated with valsartan capsules,while the observation group was treated with canagliflozin tablets in addition to the control group.Both groups were treated continuously for 3 months.Compared the treatment effect of two groups,including renal function indicators(BUN,SCR,CysC,eGFR),urinary protein indicators(ACR,24 hUTP),blood glucose indicators(FPG,2 hPG,HbA 1c),blood lipid indicators(TC,TG,HDL-C,LDL-C,hs-CRP)levels before and after treatment,as well as the occurrence of adverse reactions.Results The total effective rate of the observation group was 96.67%,which was higher than 70.00%of the control group(χ^(2)=7.680,P=0.006).After 3 months of treatment,the levels of BUN,SCr,CysC,24 hUTP,ACR,FPG,2 hPG,HbA 1c,TC,TG,LDL-C,hs-CRP in both groups decreased compared to before treatment.The levels of eGFR and HDL-C increased compared to before treatment.And the degree of decrease or increase in the above indicators in the observation group was greater than that in the control group(P<0.05 or P<0.01).There was no statistically significant difference in the total incidence of adverse reactions between the observation group and the control group(6.67%vs.3.33%,P>0.05).Conclusion The clinical efficacy of canagliflozin combined with valsartan in the treatment of early and mid-term DKD is confirmed.The two drugs have a synergistic effect on kidney protection,effectively controlling blood sugar levels,inhibiting inflammation and oxidative stress reactions in the body.At the same time,it can also reduce the patient′s urinary protein level,improve their

关 键 词：糖尿病肾病 早中期 卡格列净 缬沙坦 疗效 安全性 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]