陈 佳

目的：本文旨在研究达格列净针对CKD1期～3期患者蛋白尿进行治疗的临床降尿蛋白疗效。方法：采用前瞻性观察性研究，选取2021年1月1日至2022年12月31日在广州市中西医结合医院门诊随诊的CKD1～3期患者共80例，随机将患者分为对照组和实验组，各组40例。对照组的患者予常规的低蛋白饮食治疗联合药物厄贝沙坦片150mg bid 治疗，实验组患者在对照组患者治疗基础上增加达格列净 10mg qd进行治疗，对比两组患者在治疗前及治疗后3个月的24h尿蛋白定量、尿微蛋白和尿肌酐的比值。结果：治疗前，实验组患者的尿微量白蛋白/尿肌酐的比值、24h尿蛋白定量分别为（211.69±20.54）mm/g、（232.09±10.78）mg/24h，与对照组的患者相比（209.44±21.28）mm/g、（232.58±10.68）mg/24h，两组值均P>0.05，差异均无统计学意义。治疗3个月后实验组患者的尿微量白蛋白/尿肌酐的比值、24h尿蛋白定量分别为（128.43±19.07）mm/g、（146.81±12.56）mg/24h，均比对照组的患者数值低（150.96±18.53）mg/g、（175.87±13.26）mg/24h，P<0.05，差异有统计学意义。结论：通过本次的研究发现达格列净对CKD1期～3期患者24h尿蛋白定量、尿微量白蛋白/尿肌酐的比值均能起到很好的改善效果。

CKD1到3期；达格列净；尿蛋白

[1] Bin F,Fan Y,Jie L, et al. Amelioration of diabetic kidney injury with dapagliflozin is associated with suppressing renal HMGB1 expression and restoring autophagy in obese mice.[J]. Journal of diabetes and its complications,2023,37(3). [2] Jiajia W,Yan C,Huinan Y, et al. Sodium glucose co-transporter 2 (SGLT2) inhibition via dapagliflozin improves diabetic kidney disease (DKD) over time associatied with increasing effect on the gut microbiota in db/db mice [J]. Frontiers in Endocrinology,2023,14. [3] 张晓青,苗翠晓,陈凯庭等.德谷胰岛素联合达格列净对老年2型糖尿病患者的疗效及安全性评估[J/OL].河北医药:1-4[2023-07-31]. [4] Ah K H,Hyun Y K,Man D K, et al. Efficacy and Safety of Enavogliflozin versus Dapagliflozin as Add-on to Metformin in Patients with Type 2 Diabetes Mellitus: A 24-Week, Double-Blind, Randomized Trial.[J]. Diabetes & metabolism journal,2023. [5] 龚才伟,赵广建,刘大男等.达格列净在ox-LDL诱导形成的THP-1源性泡沫细胞焦亡中的作用[J/OL].安徽医科大学学报,2023(08):1366-1373[2023-07-31]. [6] 刘丹利,张东辉,蒿黎.益肾化湿颗粒联合常规西药对早期CKD1到3期患者肾功能、炎症损伤因子的影响[J].河南医学研究,2023,32(13):2430-2434. [7] 孙静,唐仁春.达格列净治疗糖尿病合并慢性心力衰竭的疗效及对血清微小RNA水平的影响[J].国际检验医学杂志,2023,44(13):1567-1572. [8] 王法斌,孙梦涵,赵强等.早期应用达格列净在急性心肌梗死急诊经皮冠状动脉介入术后患者中的有效性及安全性[J].实用医学杂志,2023,39(13):1688-1692. [9] S. R F,P. R S,E. D T, et al. Inhibition of SGLT2 co-transporter by dapagliflozin ameliorates tubular proteinuria and tubule-interstitial injury at the early stage of diabetic kidney disease[J]. European Journal of Pharmacology,2023,942. [10] Yan Y,Mengyao S,Zijie J, et al. Dapagliflozin ameliorates diabetic renal injury through suppressing the self-perpetuating cycle of inflammation mediated by HMGB1 feedback signaling in the kidney.[J]. European journal of pharmacology,2023,943. [11] S W W. Improving the Quality of Life for Patients With Heart Failure and Preserved Ejection Fraction.[J]. Journal of the American College of Cardiology,2023,81(5). [12] Diego C,Astrid T,Silvana L. Effects and safety of SGLT2 inhibitors compared to placebo in patients with heart failure: A systematic review and meta-analysis[J]. IJC Heart & Vasculature,2021,32.

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