达格列净联合厄贝沙坦对糖尿病肾病患者尿ACR、肾小球滤过率、 CysC水平的影响

doi:10.3969/j.issn.1007-3205.2022.08.008

河北医科大学学报 ›› 2022, Vol. 43 ›› Issue (8): 904-908.doi: 10.3969/j.issn.1007-3205.2022.08.008

达格列净联合厄贝沙坦对糖尿病肾病患者尿ACR、肾小球滤过率、 CysC水平的影响

1.上海交通大学医学院附属苏州九龙医院内分泌科，江苏苏州 215000;2.上海交通大学医学院附属苏州九龙医院肾内科，江苏苏州 215000

出版日期:2022-08-05 发布日期:2022-09-13
作者简介:李文亚（1981-），女，江苏徐州人，上海交通大学医学院附属苏州九龙医院副主任医师，医学硕士，从事糖尿病慢性病诊治研究。
基金资助:
2018年苏州市民生科技-医疗卫生应用基础研究项目（SYS2018007）

Effects of dapagliflozin combined with irbesartan on urinary ACR, glomerular filtration rate and CysC levels in patients with diabetic nephropathy

1.Department of Endocrinology, Suzhou Jiulong Hospital, Shanghai Jiao Tong University School of Medicine,
Jiangsu Province, Suzho 200051,China; 2.Department of Nephrology, Suzhou Jiulong Hospital
Affiliated to Shanghai Jiaotong University Medical College,
Jiangsu Province, Suzhou 215000， China

Online:2022-08-05 Published:2022-09-13

摘要/Abstract

摘要： 目的探究达格列净联合厄贝沙坦对糖尿病肾病患者随机尿微量白蛋白与尿肌酐比值(microalbumin/creatinine ratio，ACR)、肾小球滤过率（glomerular filtration rate，eGFR）、血清胱抑素 C(serum cystatin C，Cys C) 水平的影响。
方法选取我院收治的糖尿病肾病患者72例作为研究对象，采用随机数字法将患者分为对照组（35例）和观察组（37例）。对照组在常规治疗基础上采用厄贝沙坦治疗，观察组在对照组基础上联合达格列净治疗。分析治疗前后2组患者的尿ACR、eGFR、Cys C 、血脂指标差异，并比较2组患者治疗后不良事件发生率。
结果观察组患者治疗总有效率为89.19%（33/37），显著高于对照组的68.57%（24/35），二者比较差异有统计学意义(P＜0.05) 。治疗2个月后，2组患者总胆固醇、三酰甘油、低密度脂蛋白胆固醇等血脂指标均显著下降，且观察组血脂下降程度显著高于对照组，差异有统计学意义(P＜0.05) 。2组患者的尿ACR、Cys C水平显著下降，eGFR水平显著升高，且观察组各项指标变化值显著高于对照组，差异有统计学意义(P＜0.05)。观察组出现1例（2.70%）终点事件，显著少于对照组的6例（17.14%），差异有统计学意义(P＜0.05) 。
结论采用达格列净联合厄贝沙坦治疗DN可以有效提高患者的临床疗效和eGFR，降低患者的血脂水平、ACR和Cys C，保护患者肾功能，减少治疗后不良事件发生率，为患者预后治疗提供有利条件。

关键词: 糖尿病肾病, 达格列净, 厄贝沙坦

Abstract: Objective To explore the effects of dapagliflozin combined with irbesartan on random urine microalbumin to creatinine ratio(ACR), glomerular filtration rate（eGFR）, and serum cystatin C(Cys C) levels in patients with diabetic nephropathy.
Methods A total of 72 patients with diabetic nephropathy admitted to our hospital were selected as the research subjects. The patients were divided into a control group(35 cases) and an observation group(37 cases) by random number method. The control group was treated with irbesartan on the basis of conventional treatment, and the observation group was treated with dapagliflozin on the basis of the control group. The differences in urinary ACR, eGFR, CysC and blood lipid indexes of the two groups of patients before and after treatment were analyzed, and the incidence of adverse reactions after treatment in two groups were compared.
Results The total effective rate of treatment in the observation group was 89.19%(33/37), which was significantly higher than 68.57%(24/35) in the control group. There was a statistical difference between the two(P＜0.05). After 2 months of treatment, total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDL-C) and other blood lipid indicators in the two groups decreased significantly, and the degree of blood lipid decrease in the observation group was significantly higher than that of the control group, the difference was statistically significant(P＜0.05). The urinary ACR and Cys C levels of the two groups of patients decreased significantly, and the eGFR level increased significantly, and the changes of various indicators in the observation group were significantly higher than those of the control group, the difference was statistically significant(P＜0.05). One case(2.70%) in the observation group had an end-point event, which was significantly less than the 6 cases(17.14%) in the control group. The difference was statistically significant(P＜0.05).
Conclusion The treatment of DN with dapagliflozin combined with irbesartan can effectively improve the clinical efficacy and glomerular filtration rate of the patient, reduce the patient′s blood lipid level, the ratio of urine microalbumin to urine creatinine and serum cystatin C, and protect the patient renal function, reduce the incidence of adverse events after treatment, and provide favorable conditions for the prognosis of patients.

Key words: diabetic nephropathies, dapagliflozin, irbesartan

李文亚, 高颖, 汤颖, 邓雁北. 达格列净联合厄贝沙坦对糖尿病肾病患者尿ACR、肾小球滤过率、 CysC水平的影响 [J]. 河北医科大学学报, 2022, 43(8): 904-908.

LI Wen-ya, GAO Ying, TANG Ying, DENG Yan-bei. Effects of dapagliflozin combined with irbesartan on urinary ACR, glomerular filtration rate and CysC levels in patients with diabetic nephropathy [J]. Journal of Hebei Medical University, 2022, 43(8): 904-908.

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达格列净联合厄贝沙坦对糖尿病肾病患者尿ACR、肾小球滤过率、 CysC水平的影响

Effects of dapagliflozin combined with irbesartan on urinary ACR, glomerular filtration rate and CysC levels in patients with diabetic nephropathy

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