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 significant improvement in vascular endothelial function,atherosclerosis and renal resistance index,significant reduction in blood pressure and blood glucose,and significant increase in serum magnesium and urinary sodium.
作者
冯舒雅
任常谕
周后凤
罗雪
杨婧
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)
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)。
关键词
达格列净
2型糖尿病
血管功能
Dapagliflozin
Type 2 diabetes mellitus
Vascular function
