摘要
目的 研究达格列净治疗早期糖尿病肾病(DN)患者对其胰岛β细胞功能、糖代谢水平及肾脏致纤维化因子的影响.方法 选取我院收治的早期DN患者102例,随机分为两组,对照组51例给予常规治疗,观察组 51 例联合达格列净,对比两组患者糖代谢指标、胰岛β细胞功能指标、肾脏致纤维化因子和不良反应.结果 治疗后观察组糖化血红蛋白、餐后2 h血糖、空腹血糖水平均低于对照组(P<0.05);空腹胰岛素、稳态模型胰岛素抵抗指数水平均低于对照组,胰岛β细胞功能指数水平高于对照组(P<0.05);血清单核细胞趋化因子1、转化生长因子β1和基质金属蛋白酶组织抑制剂1水平均低于对照组(P<0.05);尿素氮、胱抑素-C、24 h尿蛋白、β2微球蛋白水平均低于对照组(P<0.05);两组患者低血糖、恶心呕吐、头晕头痛等不良反应发生率比较,P>0.05.结论 达格列净治疗早期DN患者效果明显,能够改善患者机体糖代谢状态,提高胰岛β细胞功能,降低肾脏致纤维化因子水平,安全性高.
Abstract
Objective To study the effect of dapagliflozin on pancreatic islets β cell function,glucose metabolism level and renal fibrosis factorin of patients with early diabetes nephropathy(DN).Methods 102 patients with early DN in our hospital were randomly divided into the control group(51 cases)and the observation group(51 cases).The control group received conventional treatment and the observation group received dapagliflozin on the basis of the control group.The glucose metabolism indexes,pancreatic islets β cell function index,renal fibrosis factor and adverse reaction of the two groups were compared.Results After treatment,the levels of HbA1c,2 h postprandial blood glucose and fasting blood glucose in observation group were lower than those in control group(P<0.05).After treatment,fasting insulin and homeostasis model insulin resistance index levels in observation group were lower than those in control group,but islet β cell function index level was higher than those in control group(P<0.05).After treatment,the serum levels of monocyte chemokine 1,transforming growth factor β1 and matrix metalloproteinase tissue inhibitor 1 in the observation group were lower than those in control group(P<0.05).After treatment,the levels of urea nitrogen,cystatin C,24 h urinary protein and β2 microglobulin in the observation group were lower than those in control group(P<0.05).There was no significant difference in the incidence of hypoglycemia,nausea and vomiting,dizziness and headache between the two groups(P>0.05).Conclusion Dapagliflozin has a significant effect in the treatment of early DN patients,which can improve the state of glucose metabolism,improve the function of pancreas islets β cell,reduce the level of renal fibrosis factor,is with high safety.
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