达格列净改善2型糖尿病患者肾血管功能、主动脉硬化和血管内皮功能障碍的研究  

Improvement of Dapagliflozin on Renal Vascular Function,Aortic Sclerosis and Vascular Endothelial Dysfunction in Patients with Type 2 Diabetes Mellitus

作　　者：冯舒雅 任常谕 周后凤[1] 罗雪[2] 杨婧[3] FENG Shuya;REN Changyu;ZHOU Houfeng;LUO Xue;YANG Jing(Dept.of Pharmacy,Chengdu Fifth People’s Hospital,Chengdu 611130,China;Dept.of Cardiovascular Medicine,Chengdu Fifth People’s Hospital,Chengdu 611130,China;Dept.of Endocrinology,Chengdu Fifth People’s Hospital,Chengdu 611130,China)

机构地区：[1]成都市第五人民医院药剂科,成都611130 [2]成都市第五人民医院心血管内科,成都611130 [3]成都市第五人民医院内分泌科,成都611130

出　　处：《中国医院用药评价与分析》2024年第4期435-438,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：2021年四川省卫生健康委员会医学科技项目(No.21PJ149)。

摘　　要：目的:探讨达格列净对2型糖尿病(T2DM)患者肾血管功能、主动脉硬化和血管内皮功能障碍的影响。方法:纳入2022年3月至2023年8月于该院内分泌科治疗的T2DM患者278例,根据随机数字表法分为达格列净组(n=139)与对照组(n=139)。对照组患者给予二甲双胍片口服治疗,1次0.5 g, 1日2次;达格列净组在对照组的基础上给予达格列净片口服治疗,1次10 mg, 1日1次,早晨服用。所有患者均连续治疗4周。比较达格列净组与对照组患者治疗前后血清指标、尿液指标、血压和血管功能指标水平。结果:治疗后,达格列净组患者空腹血糖水平较对照组同期显著降低(t=2.815,P=0.005),24 h尿量(t=5.166,P<0.001)、尿钠(t=2.021,P=0.044)、自由水清除率(t=21.971,P<0.001)和血清镁(t=6.863,P<0.001)水平较对照组同期显著升高,血清去甲肾上腺素水平较对照组同期显著降低(t=6.279,P<0.001),差异均有统计学意义。治疗后,达格列净组患者收缩压较对照组同期显著降低(t=3.426,P=0.001),脉搏波传导速度较对照组同期显著减慢(t=4.790,P<0.001),血流介导的血管舒张功能较对照组同期显著升高(t=9.316,P<0.001),差异均有统计学意义。治疗后,达格列净组患者肾阻力指数较对照组同期显著降低,差异有统计学意义(t=6.038,P<0.001)。结论:T2DM患者采用达格列净治疗后,血管内皮功能、动脉硬化和肾阻力指数显著改善,血压、血糖水平显著降低,血清镁、尿钠水平显著升高。OBJECTIVE:To probe into the effects of dapagliflozin on renal vascular function,aortic sclerosis and vascular endothelial dysfunction in patients with type 2 diabetes mellitus(T2DM).METHODS:A total of 278 patients with T2DM treated in the endocrinology department of the hospital from Mar.2022 to Aug.2023 were extracted to be divided into the dapagliflozin group(n=139)and control group(n=139)according to the random number table method.The control group was treated with Metformin tablets orally,twice a day,0.5 g each time.On the basis of treatment in the control group,the dapagliflozin group was given oral treatment of Dapagliflozin tablets,once a day in the morning,10 mg each time.All patients were treated continuously for 4 weeks.The serum,urine,blood pressure and vessel function indicators were compared before and after treatment between the dapagliflozin group and control group.RESULTS:After treatment,the fasting blood glucose of the dapagliflozin group decreased significantly compared with the control group during the same period(t=2.815,P=0.005),24 h urine volume(t=5.166,P<0.001),urinary sodium(t=2.021,P=0.044),free water clearance(t=21.971,P<0.001),and serum magnesium(t=6.863,P<0.001)increased significantly compared with the control group during the same period,while serum norepinephrine decreased significantly compared with the control group at the same period(t=6.279,P<0.001),with statistically significant differences.After treatment,the systolic blood pressure(t=3.426,P=0.001)and pulse wave velocity(t=4.790,P<0.001)in the dapagliflozin group decreased significantly compared with the control group,while the flow-mediated dilation increased significantly compared with the control group(t=9.316,P<0.001),with statistically significant differences.After treatment,the renal resistance index of dapagliflozin group decreased significantly compared with the control group during the same period,with statistically significant difference(t=6.038,P<0.001).CONCLUSIONS:T2DM patients treated with dapagliflozin shows sign

关 键 词：达格列净 2型糖尿病 血管功能 

分 类 号：R977.15[医药卫生—药品]