摘要目的 观察恩格列净治疗2型糖尿病肾病的临床疗效。方法 选取2018年12月～2020年2月北京市房山区第一医院收治的40例2型糖尿病肾病患者作为研究对象，采用随机数字表法分为对照组（20例）和研究组（20例）。在原有降糖药、肾素血管紧张素系统阻断剂、他汀类药物治疗的基础上，对照组加用西格列汀，研究组加用恩格列净，治疗24周。比较两组患者的空腹血糖（FPG）、餐后2小时血糖（2 h PG）、糖化血红蛋白（HbA1c）、血脂[包括三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）]、血尿酸（UA）、体重指数（BMI）、血压[包括收缩压（SBP）和舒张压（DBP）]以及尿白蛋白肌酐比（ACR）、估算肾小球滤过率（eGFR）指标，记录不良反应发生情况。结果 治疗后，两组FPG、2 h PG、HbA1c水平低于治疗前，差异有统计学意义（P＜0.01）。治疗后，研究组FPG、2 h PG、HbA1c水平与对照组比较，差异无统计学意义（P＞0.05）。治疗后，两组TG水平低于治疗前，且研究组低于对照组，差异有统计学意义（P＜0.05）。治疗后，两组HDL-C水平高于治疗前，且研究组高于对照组，差异有统计学意义（P＜0.05）。治疗前后，TC、LDL-C水平组间与组内比较，差异无统计学意义（P＞0.05）。治疗后，两组UA、BMI、SBP、DBP、ACR低于治疗前，且研究组低于对照组，差异有统计学意义（P＜0.05）。治疗前后，eGFR组间与组内比较，差异无统计学意义（P＞0.05）。两组均无明显不良反应发生。结论 恩格列净治疗2型糖尿病肾病可以有效减少尿蛋白排泄量，延缓糖尿病肾病进展，安全性良好，值得临床推广应用。
Abstract：Objective To observe the clinical efficacy of Empagliflozin in the treatment of early type 2 diabetic nephropathy.Methods A total of 40 patients with type 2 diabetic nephropathy admitted to Fangshan District First Hospital of Beijing from December 2018 to February 2020 were selected as the research objects,and divided into the control group(20 cases)and the study group(20 cases)according to the random number table method.On the basis of the original hypoglycemic agents,renin angiotensin system blockers and the statins,the control group was treated with Siglitazine,and the study group was treated with Empagliflozin,both groups were treated for 24 weeks.Fasting plasma glucose(FPG),2 hours postprandial blood glucose(2 h PBG),glycosylated hemoglobin(HbA1c),blood lipid(including triacylglycerol[TG],total cholesterol[TC],high density lipoprotein cholesterol[HDL-C],low density lipoprotein cholesterol[LDL-C]),uric acid(UA),body mass index(BMI),blood pressure(including systolic pressure[SBP]and diastolic pressure[DBP]),albumin-to-creatinine ratio(ACR)and estimated glomerular filtration rate(eGFR)were compared between the two groups,and adverse reactions were recorded.Results After treatment,the levels of FPG,2 h PG and HbA1c in the two groups were lower than those before treatment,and the differences were statistically significant(P＜0.01).After treatment,there was no significant difference in the levels of FPG,2 h PG,HbA1c between the study group and the control group(P＞0.05).After treatment,the TG levels of the two groups were lower than those before treatment,and the TG level of the study group was lower than that of the control group,the differences were statistically significant(P＜0.05).The HDL-C levels of the two groups were higher than those before treatment,and the HDL-C level of the study group was higher than that of the control group,the differences were statistically significant(P＜0.05).Before and after treatment,there were no significant difference of the TC and LDL-C levels between the two groups(P＞0.05).After treatment,the levels of UA,BMI,SBP,DBP,ACR in the two groups were lower than those before treatment,and the levels of UA,BMI,SBP,DBP,ACR in the study group was lower than that in the control group,the differences were statistically significant(P＜0.05).Before and after treatment,there was no significant difference of the eGFR level between the two groups(P＞0.05).There was no obvious adverse reaction in both groups.Conclusion Empagliflozin treatment of early type 2 diabetic nephropathy can effectively reduce urinary protein excretion,delay the progression of diabetic nephropathy,and good safety,which is worthy of clinical application.
刘红丹； 范静. 恩格列净治疗2型糖尿病肾病的临床观察[J]. 中国当代医药, 2021, 28(14): 84-88.
LIU Hong-dan； FAN Jing. Clinical observation of Empagliflozin in the treatment of type 2 diabetic nephropathy. 中国当代医药, 2021, 28(14): 84-88.
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