农庆笑,韦 华

糖尿病肾病是糖尿病最严重的并发症之一，微量白蛋白尿多见于肾病早期，一些患者在积极治疗后可能复发。肾功能受损后其进展远快于其它肾小球疾病，从蛋白尿出现到尿毒症患者死亡的中位时间约为10年，本文通过检索有关文献对糖尿病肾病的西医治疗进展作一论述，以期对临床实践有更多借鉴。

糖尿病肾病；西医治疗；研究进展

[1]张伟,黄洁.钠-葡萄糖共转运蛋白 2 抑制剂治疗 2 型糖尿病心肾并发症的研究进展[J].武警医学,2024,35(01):75-79. [2]Zannad F,Ferreira JP,Pocock SJ,Anker SD,Butler J,Filippatos G,Brueckmann M,Ofstad AP,Pfarr E,Jamal W,Packer M.SGLT2 inhibitors in patients with heart failure with reduced ejection fraction:a meta-analysis of the EMPEROR-Reduced and DAPA-HF trials.Lancet.2020 Sep 19;396(10254):819-829. [3]郑建智.新四联疗法与“金三角”方案在射血分数下降心力衰竭中的对比研究[J].心血管病防治知识,2023,13(25):3-5. [4]沈舒云.胰高血糖素样肽-1 受体激动剂对 2 型糖尿病患者的心血管结局[J].世界临床药物,2022,43(09):1199-1206. [5]中华医学会内分泌学分会,中华医学会糖尿病学分会.胰高糖素样肽-1(GLP-1)受体激动剂用于治疗 2 型糖尿病的临床专家共识[J]. 中华内科杂志,2020,59(11):836-846. [6]傅劲超,任菁菁.胰高血糖素样肽-1 受体激动剂司美格鲁肽和聚乙二醇洛塞那肽治疗肥胖症的研究进展[J].中国药物经济 学,2023,18(12):116-121. [7]Davies MJ,Aroda VR,Collins BS,et al.Management of Hyperglycemia in Type 2 Diabetes,2022.A Consensus Report by the American Diabetes Association(ADA)and the European Association for the Study of Diabetes(EASD).Diabetes Care.2022;45(11):2753-2786. [8]Jia R,Zhang X,Xu Y,et al.Effect of Sacubitril/Valsartan on renal function in patients with chronic kidney disease and heart failure with preserved ejection fraction:A real-world 12-week study.Eur J Pharmacol.2022;928:175053. [9]中华医学会糖尿病学分会,国家基本公共卫生服务项目基层糖尿病防治管理办公室.国家基层糖尿病肾脏病防治技术指南 (2023)[J].中华内科杂志,2023,62(12):1394-1405. [10]Fried LF,Emanuele N,Zhang JH,et al.Combined angiotensininhibition for the treatment of diabetic nephropathy.N Engl J Med,2013,369(20):1892-1903. [11]Bhandari S,Mehta S,Khawaja A,Cleland JGF,Ives N,Cockwell P.Evaluation of the stopping angiotensin converting enzyme inhibitor compared to angiotensin receptor blocker(STOP ACEi trial)in advanced and progressive chronic kidney disease.Kidney Int.2024;105(1):200-208. [12]陈丽萍.双 RAS 重肾素-血管紧张素系统阻断治疗 1~3a 期糖尿病肾病的效果分析[J].中国医学创新,2023,20(15):21-25. [13]Filippatos G,Anker SD,Agarwal R,et al.Finerenone Reduces Risk of Incident Heart Failure in Patients With Chronic Kidney Disease and Type 2 Diabetes:Analyses From the FIGARO-DKD Trial.Circulation.2022;145(6):437-447.[14]龚卫月,王利敏,王青华.非奈利酮对糖尿病肾病患者肾脏和心血管结局影响的研究进展[J].中国现代医生,2024,62(03):135-139. [15]Hiddo J L Heerspink et al.Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease(SONAR):a double-blind,randomised,placebo-controlled trial.Lancet,April 14 2019. [16]eerspink HJL,Kiyosue A,Wheeler DC,et al.Zibotentan in combination with dapagliflozin compared with dapagliflozin in patients with chronic kidney disease(ZENITH-CKD):a multicentre,randomised,active-controlled,phase 2b,clinical trial.Lancet.2023;402(10416):2004-2017. [17]Shayanpour S,Mehri A,Hayati F,Zakerkish M,Beladi Mousavi SS,Hoseinynejad K.Determination of pentoxifylline efficacy on microalbuminuria in patients with type-2 diabetes.Recenti Prog Med.2024;115(1):15-20. [18]Salama RAM,Raafat FA,Hasanin AH,et al.A neuroprotective effect of pentoxifylline in rats with diabetic neuropathy:Mitigation of inflammatory and vascular alterations.Int Immunopharmacol.2024;128:111533. [19]徐晓宏,朱爱民,米侠,张策,孙涛.腹膜透析与血液透析在终末期糖尿病肾病治疗中的临床疗效[J].系统医学,2023,8(22):111-114. [20]赵小莹,马聪,吕睿婷.分析自动化腹膜透析治疗尿毒症伴充血性心力衰竭患者的效果[J].中国医疗器械信息,2023,29(07):132-134. [21]陈石生.血液透析治疗糖尿病肾病肾功能衰竭的应用及疗效探析[J].中国社区医师,2021,37(13):21-22. [22]武燕,师璟,武晓圆.对比分析高通量与低通量血液透析治疗糖尿病肾病的疗效及对患者炎症反应､氧化应激的影响[J].糖尿病新 世界,2023,26(16):189-193. [23]张江伟,王颖,石玉婷,郑瑾,张静,郝琳,李潇,丁小明.糖尿病终末期肾病患者肾移植围术期并发症的特点及移植效果分析[J].实用器 官移植电子杂志,2022,10(05):423-428. [24]Porrett PM,Orandi BJ,Kumar V,et al.First clinical-grade porcine kidney xenotransplant using a human decedent model.Am J Transplant.2022;22(4):1037-1053. [25]谢思雨,路君.间充质干细胞疗法在肾移植中的应用:一个未完待续的故事[J].器官移植,2024,15(03):398-405.

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