标题:达格列净联合依那普利治疗2型糖尿病肾病的疗效及对患者血清Cys-C、Hcy水平的影响
作者:黄家锋,沓世泽,欧玉玲 罗定市人民医院内三科,广东 云浮 527200
卷次:
2022年33卷9期
【摘要】 目的 观察达格列净联合依那普利治疗2型糖尿病肾病的疗效,并探讨其对患者血清胱抑素C (Cys-C)、同型半胱氨酸(Hcy)水平的影响。方法 选取2019年7月至2020年12月于罗定市人民医院内三科治疗的108例2型糖尿病肾病患者为研究对象,依据随机单双数法分为对照组与联合组各54例。对照组患者采用依那普利治疗,联合组患者在对照组治疗的基础上应用达格列净治疗。治疗3个月后,比较两组患者的临床疗效、血压、体质指数(BMI)、空腹静脉血糖(FBG)、糖化血红蛋白(HbA1c)、24 h尿蛋白定量、甘油三酯(TG)、总胆固醇(TC)水平,以及治疗前及治疗3个月后的Cys-C、Hcy水平。结果 联合组患者的治疗总有效率为94.44%,明显高于对照组的77.78%,差异有统计学意义(P<0.05);联合组患者的收缩压、舒张压、BMI、FBG、HbA1c、24 h尿蛋白定量、TC水平明显低于对照组,差异均有统计学意义(P<0.05),但两组患者的TG水平比较差异无统计学意义(P>0.05);治疗后联合组患者的Cys-C、Hcy水平分别为(0.95±0.50) μmol/L、(12.83±6.82) mg/L,对照组的Cys-C、Hcy水平分别为(1.43±0.79) μmol/L、(26.25±11.73) mg/L,明显低于其治疗前的(1.73±0.79) μmol/L、(35.03±17.37) mg/L和(1.72±0.83) μmol/L、(34.86±17.94) mg/L,且联合组患者治疗后的Cys-C、Hcy水平明显低于对照组,差异均有统计学意义(P<0.05)。结论 达格列净联合依那普利治疗2型糖尿病肾病有显著疗效,同时可以使血清Cys-C、Hcy水平得到有效降低,值得临床推广应用。
【关键词】 2型糖尿病肾病;达格列净;依那普利;血清胱抑素C;同型半胱氨酸;疗效
【中图分类号】 R587.1 【文献标识码】 A 【文章编号】 1003—6350(2022)09—1126—04
Efficacy of dapagliflozin combined with enalapril in patients with type 2 diabetic nephropathy and its effect onserum Cys-C and Hcy levels.
HUANG Jia-feng, DA Shi-ze, OU Yu-ling. The Third Department of Internal Medicine,Luoding People's Hospital, Yunfu 527200, Guangdong, CHINA
【Abstract】 Objective To observe the efficacy of dapagliflozin combined with enalapril in the treatment oftype 2 diabetic nephropathy, and to explore its effect on serum cystatin C (Cys-C) and homocysteine (Hcy) levels.Methods A total of 108 patients with type 2 diabetic nephropathy treated in the Third Department of Internal Medi-cine, Luoding People's Hospital from July 2019 to December 2020 were selected as the research objects. According tothe random odd and even number method, the patients were divided into the control group and the combined group,with 54 patients in each group. The patients in the control group were treated with enalapril, and the patients in thecombined group were treated with dapagliflozin on the basis of the treatment in the control group. After 3 months oftreatment, the clinical efficacy, blood pressure, body mass index (BMI), fasting venous blood glucose (FBG), glycosyl-ated hemoglobin (HbA1c), 24 h urinary protein, triglyceride (TG), total cholesterol (TC) levels, Cys-C, and Hcy levelsbefore and after 3 months of treatment were compared between the two groups. Results The total effective rate of thecombined group was 94.44%, which was significantly higher than 77.78% in the control group (P<0.05). The levels ofsystolic blood pressure, diastolic blood pressure, BMI, FBG, HbA1c, 24 h urinary protein, and TC in the combinedgroup were significantly lower than those in the control group (P<0.05), but there was no significant difference in the lev-el of TG between the two groups (P>0.05). After treatment, the levels of Cys-C and Hcy in the combined group were(0.95±0.50) μmol/L, (12.83±6.82) mg/L, the levels of Cys-C and Hcy in the control group were (1.43±0.79) μmol/L,(26.25±11.73) mg/L, significantly lower than (1.73±0.79) μmol/L, (35.03±17.37) mg/L and (1.72±0.83) μmol/L, (34.86±17.94) mg/L before treatment; and the levels of Cys-C and Hcy in the combined group were significantly lower thanthose in the control group (P<0.05). Conclusion Dapagliflozin combined with enalapril has a significant effect in thetreatment of type 2 diabetic nephropathy. At the same time, it can effectively reduce the serum Cys-C and Hcy levels,which is worthy of application and promotion.
【Key words】 Type 2 diabetic nephropathy; Dapagliflozin; Enalapril; Serum cystatin C; Homocysteine; Curativeeffect
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