摘要
目的探讨达格列净治疗早期糖尿病肾病的疗效及对血清肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)水平的影响。方法选择浙江中医药大学滨江学院附属富阳第一医院肾内科于2019年1月至2020年4月期间收治的82例早期糖尿病肾病患者,随机分为两组,每组各41例,两组患者均予口服厄贝沙坦治疗,对照组予口服二甲双胍片降糖治疗,观察组予达格列净片降糖治疗。比较两组患者治疗前后空腹血糖(fasting plasma glucose,FPG)、餐后2 h血糖(2 h postprandial blood glucose,2 hPG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)和血肌酐(Scr)、胱抑素C(cystatin C,Cys C)、尿白蛋白排泄率(urinary albumin excretion rate,UAER)水平的变化,及血清TNF-α、IL-6水平的变化。结果治疗后,观察组与对照组的FPG、2 hPG及HbA1c均明显降低,且观察组均明显低于对照组,差异有统计学意义(P<0.05);治疗后,两组的Scr水平与治疗前及两组间比较,差异无统计学意义(P>0.05);治疗后,两组患者的UAER及血清Cys C水平均明显降低,且观察组均明显低于对照组,差异有统计学意义(P<0.05);治疗后,两组患者的血清TNF-α、IL-6水平均明显降低,且观察组均明显低于对照组,差异有统计学意义义(P<0.05)。结论达格列净治疗早期糖尿病肾病可有效控制患者的血糖,同时降低血清TNF-α、IL-6水平,减少尿蛋白、保护肾功能。
Objective To investigate the efficacy of dapagliflozin in the treatment of early diabetic kidney disease and its effects on serum tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels.Methods A total of 82 patients with early diabetic kidney disease admitted to the department of nephrology of our hospital from January 2019 to April 2020 were selected and randomly divided into two groups,with 41 patients in each group.Patients in both groups were treated with oral irbesartan.In addition,patients in the control group was treated with oral metformin tablets to lower blood glucose,while those in the observation group was treated with dapagliflozin tablets to lower blood glucose.The changes of fasting plasma glucose(FPG),2 h postprandial blood glucose(2 hPG),hemoglobin A1c(HbA1c),serum creatinine(Scr),cystatin C(Cys C),urinary albumin excretion rate(UAER),and serum TNF-α and IL-6 levels before and after treatment were compared between the two groups.Results After treatment,FPG,2 hPG and HbA1c levels in the observation group and the control group were significantly lower than those before treatment,and these indices in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).In both groups,there was no statistically significant difference in Scr levels before and after treatment,meanwhile,there was no statistically significant difference in Scr levels between the two groups after treatment(P>0.05).After treatment,UAER and serum Cys C levels in both groups were significantly lower than those before treatment,and these indices in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).After treatment,serum TNF-α and IL-6 levels in both groups were significantly lower than those before treatment,and these indices in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).Conclusion In the treatment of early diabetic kidney disease,dapagliflozin can effectively control patients'blood glucose,and at the same time can reduce serum TNF-α and IL-6 levels,reduce urinary protein and protect renal function.
作者
赵梦萍
孔祥栋
陈肖蓉
盛丹虹
ZHAO Mengping;KONG Xiangdong;CHEN Xiaorong;SHENG Danhong(Department of Nephrology,the First People's Hospital of Fuyang District in Hangzhou City,Fuyang First Hospital Affiliated to Binjiang College of Zhejiang Chinese Medical University,Hangzhou 311400,China)
出处
《中国现代医生》
2022年第14期33-36,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2020ZH030)。
