达格列净联合血管紧张素转换酶抑制剂在糖尿病肾病蛋白尿患者临床治疗中的应用效果分析  

Analysis of the Effectiveness of the Application of Dapagliflozin Combined with Angiotensin-converting Enzyme Inhibitors in the Clinical Treatment of Patients with Proteinuria in Diabetic Nephropathy

作　　者：夏娟 XIA Juan(Department of Nephrology,Suining County People's Hospital,Suining,Jiangsu Province,221200 China)

机构地区：[1]睢宁县人民医院肾内科,江苏睢宁221200

出　　处：《系统医学》2024年第5期94-97,101,共5页Systems Medicine

摘　　要：目的分析达格列净联合血管紧张素转换酶抑制剂在糖尿病肾病蛋白尿患者临床治疗中的应用效果。方法选取睢宁县人民医院于2021年1月—2023年3月收治的78例糖尿病肾病患者作为研究对象,根据随机数表法将其分为两组,均给予控糖治疗。对照组(n=38)给予血管紧张素转换酶抑制剂治疗(盐酸贝那普利片),观察组(n=40)在对照组治疗基础上联合达格列净治疗。比较两组患者治疗前后尿微量蛋白(Urine Microprotein,mALB)、24 h尿蛋白定量、血清白蛋白(Albumin,ALB)水平、血糖水平以及并发症发生情况。结果治疗后,观察组mALB[(167.12±23.15)mg/L]、24 h尿蛋白定量[(1.04±0.28)g/24 h]均低于对照组[(342.52±35.26)mg/L、(1.72±0.62)g/24 h],差异有统计学意义(P均<0.05);血清ALB水平[(33.74±1.16)g/L]高于对照组(31.93±0.85)g/L,差异有统计学意义(P<0.05)。治疗后,观察组的空腹血糖[(5.16±1.67)mmol/L]低于对照组[(6.69±2.24)mmol/L],餐后2h血糖[(6.59±2.05)mmol/L]低于对照组[(8.76±3.25)mmol/L],糖化血红蛋白[(4.35±1.86)%]低于对照组[(6.26±2.85)%],差异有统计学意义(t=3.432、3.546、3.522,P均<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论在糖尿病肾病蛋白尿患者的临床治疗中,达格列净联合血管紧张素转换酶抑制剂的应用效果较为显著。Objective To analyze the effect of dapagliflozin combined with angiotensin-converting enzyme inhibitor in the clinical treatment of proteinuria patients with diabetic nephropathy.Methods A total of 78 patients with diabetic nephropathy admitted to Suining County People's Hospital from January 2021 to March 2023 were selected as the study objects,and were divided into two groups according to random number table method.The control group(n=38)was treated with angiotensin-converting enzyme inhibitor(Benazepril hydrochloride tablet),and the observation group(n=40)was treated with daglipzin on the basis of the control group.Urine microprotein(mALB),24 h urinary protein,serum albumin(ALB)level,blood glucose level and complications were compared between the two groups before and after treatment.Results The mALB[(167.12±23.15)mg/L]and urinary protein quantity[(1.04±0.28)g/24 h]in obser⁃vation group were lower than those in control group[(342.52±35.26)mg/L and(1.72±0.62)g/24 h],and the differences were statistically significant(both P<0.05).Serum ALB level[(33.74±1.16)g/L]was higher than that of control group[(31.93±0.85)g/L],and the difference was statistically significant(P<0.05).After treatment,fasting plasma glucose[(5.16±1.67)mmol/L]in the observation group was lower than that in the control group[(6.69±2.24)mmol/L],and 2 h postprandial blood glucose[(6.59±2.05)mmol/L]was lower than that in the control group[(8.76±3.25)mmol/L],and glycosylated haemoglobin[(4.35±1.86)%]was lower than control group[(6.26±2.85)%],and the differences were statistically significant(t=3.432,3.546,3.522,all P<0.05).The incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion In the clinical treatment of diabetic nephropathy proteinuria,the application of daglipzin combined with angiotensinconverting enzyme inhibitors is more significant.

关 键 词：达格列净 血管紧张素转换酶抑制剂 盐酸贝纳普利片 糖尿病肾病 蛋白尿 

分 类 号：R4[医药卫生—临床医学]