摘要
目的探讨羟苯磺酸钙联合沙格列汀治疗早期糖尿病肾病(DKD)的效果及对氧化应激指标的影响。方法选取2017年12月至2019年6月本院收治的97例早期DKD患者为研究对象,随机将其分为观察组(49例)和对照组(48例)。对照组采用羟苯磺酸钙治疗,观察组采用羟苯磺酸钙联合沙格列汀治疗。比较两组的疗效、血清炎性因子、氧化应激指标、血糖指标、肾功能指标及不良反应发生率。结果观察组的总有效率显著高于对照组(P<0.001)。治疗前,两组的空腹血糖(FPG)、餐后2 h血糖(2hFG)、血肌酐(Scr)、血尿素氮(BUN)、尿白蛋白排泄率(UAER)、尿白蛋白/尿肌酐(UACR)、估算肾小球滤过率(eGFR)比较,差异均无统计学意义(均P>0.05);治疗后,两组的FPG、2hFG、Scr、BUN、UAER、UACR、eGFR比较,差异均有统计学意义(均P<0.05);治疗后,观察组的FPG、2hFG、Scr、BUN、UAER、UACR显著低于对照组,eGFR显著高于对照组(均P<0.05)。治疗前,两组的血清白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、白介素-18(IL-18)水平比较,差异均无统计学意义(均P>0.05)。治疗后,两组的血清IL-6、hs-CRP、IL-18水平均较治疗前显著降低(均P<0.05),与对照组比较,观察组的血清IL-6、hs-CRP、IL-18水平更低(均P<0.05)。治疗前,两组的血清超氧化物歧化酶(SOD)、丙二醛(MDA)、晚期氧化蛋白产物(AOPP)、中晚期糖基化终末产物(AGE)比较,差异均无统计学意义(均P>0.05);治疗后,两组的血清SOD、MDA、AOPP、AGE水平较治疗前显著改善(均P<0.05);治疗后,观察组的血清SOD较对照组更高,MDA、AOPP、AGE更低(均P<0.05)。两组的不良反应发生率比较,差异无统计学意义(4.2%vs.4.1%,P>0.05)。结论羟苯磺酸钙联合沙格列汀治疗早期DKD的效果显著,能有效改善患者的肾功能和氧化应激反应。
Objective To investigate the effect of calcium dobesilate combined with shagliptin in the treatment of early diabetic kidney disease(DKD)and its effect on oxidative stress indicators.Methods A total of 97 patients with early DKD admitted to our hospital from December 2017 to June 2019 were selected as the research objects.The patients were randomly divided into observation group(49 cases)and control group(48 cases).The control group was treated with calcium dobesilate,and the observation group was treated with calcium dobesilate combined with saxagliptin.The treatment effect,renal function indexes,serum inflammatory factors,oxidative stress indexes,blood glucose index,renal function indexes and the incidence of adverse reactions were compared between the two Results The total effective rate of the observation group was significantly higher than that of the control group(P<0.001).There was no significant difference in fasting blood glucose(FPG),2-h postprandial blood glucose(2hFG),serum creatinine(Scr),blood urea nitrogen(BUN),urinary albumin excretion rate(UAER),urinary albumin/creatinine(UACR),and estimated glomerular filtration rate(eGFR)between the two groups before treatment(all P>0.05).There were significant differences in FPG,2hFG,Scr,BUN,UAER,UACR and EGFR between the two groups before and after treatment(all P<0.05).After treatment,FPG,2hFG,Scr,BUN,UAER and UACR in the observation group were significantly lower than those in the control group,and EGFR was significantly higher than those in the control group(all P<0.05).There was no significant difference in the levels of serum interleukin-6(IL-6),high sensitivity C-reactive protein(hs-CRP)and interleukin-18(IL-18)between the two groups before treatment(all P>0.05).Compared with before treatment,the levels of serum IL-6,hs-CRP and IL-18 in the two groups decreased significantly after treatment(all P<0.05),and the levels of serum IL-6,hs-CRP and IL-18 in the observation group were lower than those in the control group(all P<0.05).Before treatment,there was no significant difference in serum superoxide dismutase(SOD),malondialdehyde(MDA),advanced oxidized protein products(AOPP)and advanced glycation end products(AGE)between the two groups(all P>0.05).Compared with before treatment,the levels of serum SOD,MDA,AOPP and AGE in the two groups were significantly improved after treatment(all P<0.05).Compared with the control group,the serum SOD of the observation group was higher and MDA,AOPP and AGE were lower after treatment(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Calcium dobesilate combined with saxagliptin has a significant effect on the treatment of early DKD,which can effectively improve the renal function and oxidative stress response of patients.
作者
张建平
蒋志远
Zhang Jianping;Jiang Zhiyuan(Department of Endocrinology,Liuhe Hospital Affiliated to Medicine College of Yangzhou University,Nanjing 211500,China)
出处
《国际泌尿系统杂志》
2022年第5期880-884,共5页
International Journal of Urology and Nephrology
关键词
糖尿病肾病
羟苯磺酸钙
沙格列汀
氧化应激
Diabetic Nephropathies
Calcium Dobesilate
Saxagliptin
Oxidative Stress
