达格列净联合缬沙坦对糖尿病肾病合并高血压患者大量蛋白尿的影响  

Effect of Dapagliflozin Combined with Valsartan on Massive Proteinuria in Patients with Diabetic Nephropathy Complicated with Hypertension

作　　者：吴兵 WU Bing(Department of Endocrinology,Yixing Second People's Hospital(Yixing Occupational Disease Prevention and Control Hospital),Yixing,Jiangsu Province,214221 China)

机构地区：[1]宜兴市第二人民医院(宜兴市职业病防治院)内分泌科,江苏宜兴214221

出　　处：《糖尿病新世界》2023年第24期16-19,共4页Diabetes New World Magazine

摘　　要：目的探讨临床治疗糖尿病肾病合并高血压以达格列净、缬沙坦双药联用方式的效果及对蛋白尿的影响。方法选取2018年6月—2022年6月宜兴市第二人民医院接诊的84例糖尿病肾病合并高血压患者为研究对象,按照随机数表法进行分组,对照组(n=42)以二甲双胍联用缬沙坦治疗,观察组(n=42)以二甲双胍、缬沙坦、达格列净联合治疗;分别于患者入院时、用药12周后对血糖及血压指标进行检测;同时检测两组患者治疗前后尿蛋白指标,两组患者用药后产生的不良反应。结果持续用药治疗后,患者血糖及血压指标下降,肾功能指标好转,其中观察组血糖值、血压值均低于对照组,尿蛋白各指标测定结果低于对照组,差异有统计学意义(P均<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论临床治疗糖尿病肾病合并高血压可采取联合用药方式,首选达格列净、缬沙坦联合治疗,相较单用缬沙坦控糖、降压效果更佳,同时有效降低尿蛋白水平,改善患者肾功能,减少不良反应。Objective To investigate the clinical treatment of diabetic nephropathy complicated with hypertension with dapagliflozin and valsartan and its effect on proteinuria.Methods A total of 84 diabetic nephropathy patients with hypertension admitted to the second people Hospital of Yixing from June 2018 to June 2022 were selected di-vided into two groups,grouped according to the random number table method,the control group(n=42)was treated with metformin and valsartan,while the observation group(n=42)was treated with metformin,Valsartan and dapa-gliflozin.Blood glucose and blood pressure indexes were detected at admission and 12 weeks after medication,Urine protein indexes were detected before and after treatment in both groups.The adverse reactions of the two groups were compared.Results After continuous drug treatment,blood glucose and blood pressure indexes of the patients de-creased,renal function indexes improved,and blood glucose and blood pressure values of the observation group were lower than those of the control group,and urinary protein indexes were lower than those of the control group,the differ-ences were statistically significant(all P<0.05).The total incidence of adverse reactions was compared between the two groups,the difference was not statistically significant(P>0.05).Conclusion In the clinical treatment of diabetic nephropathy complicated with hypertension,the combination of dapagliflozin and valsartan is the first choice.Com-pared with valsartan alone,the combination of dapagliflozin and valsartan has better effects on glucose control and blood pressure reduction,and it can effectively reduce the urinary protein level,improve the kidney function of pa-tients reduce adverse reactions.

关 键 词：达格列净 缬沙坦 糖尿病肾病 高血压 蛋白尿 

分 类 号：R587[医药卫生—内分泌]