达格列净联合依那普利对糖尿病肾病患者肾功能、尿足细胞相关蛋白和炎症因子的影响
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湖北省自然科学基金面上项目(2020CFB634);


Effects of dapagliflozin combined with enalapril on renal function,urinary podocyte-associated protein and inflammatory factors in patients with dia-betic nephropathy
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    摘要:

    目的:探讨达格列净联合依那普利治疗糖尿病肾病(DN)的疗效。方法:将160例DN患者按治疗方案不同分为对照组与观察组,每组各80例。对照组与观察组分别予以依那普利、达格列净联合依那普利,均治疗12周。于治疗前后,检测患者24 h尿蛋白定量(24 h UAE)、尿白蛋白与肌酐之间比值(ACR)、血肌酐(Scr)、尿素氮(BUN)和预估肾小球滤过率(eGFR)水平,并测定患者尿液膜蛋白(Podocin)、足细胞裂孔膜蛋白(Nephrin)和血清白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平,记录并比较两组疗效和不良反应发生情况。结果:观察组治疗有效率高于对照组(P<0.05)。治疗后,观察组24 h UAE水平、ACR值、Scr、BUN均低于对照组(P<0.05),eGFR水平高于对照组(P<0.05);尿Podocin水平、Nephrin和血清IL-6、TNF-α低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:达格列净联合依那普利治疗能够更有效地减轻患者蛋白尿,改善肾功能,提高对DN的疗效,其机制可能与抑制炎症、缓解足细胞损伤有关。

    Abstract:

    Objective:To investigate the efficacy of dapagliflozin combined with enalapril in the treatment of diabetic nephropa-thy(DN).Methods:A total of 160 patients with DN were divided into control group and observation group according to different treat-ment methods,with 80 cases in each group.The two groups were treated with enalapril and dapagliflozin combined with enalapril respec-tively for 12 weeks.Before and after treatment,the levels of 24 h urinary protein quantification(24 h UAE),urinary albumin to creati-nine ratio(ACR),serum creatinine(Scr),urea nitrogen(BUN)and estimated glomerular filtration rate(eGFR)were detected,and the levels of urine membrane protein(Podocin),podocyte slit diaphragm protein(Nephrin)and serum interleukin 6(IL-6),tumor necrosis factor α(TNF-α)were measured.The efficacy and adverse reactions of the two groups were compared.Results:The total ef-fective rate of the observation group was higher than that of the control group(P<0.05).After treatment,compared with the control group,the 24 h UAE level,ACR value,Scr and BUN in the observation group decreased(P<0.05),and the eGFR level increased(P<0.05).The levels of urinary Podocin,Nephrin,serum IL-6,and TNF-α in the observation group were lower than those in the con-trol group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Dapagliflozin combined with enalapril can more effectively reduce proteinuria,improve renal function and im-prove the efficacy of DN.The mechanism may be related to inhibiting inflammation and alleviating podocyte injury.

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连欢;胡纯;邓旋;吴婷;.达格列净联合依那普利对糖尿病肾病患者肾功能、尿足细胞相关蛋白和炎症因子的影响[J].川北医学院学报,2025,40(6):719-722.

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  • 在线发布日期: 2025-07-09
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