目的:探讨血管紧张素Ⅱ受体阻滞剂(ARB)联合钠-葡萄糖协同转运蛋白 2(SGLT2)抑制剂治疗慢性肾小球肾炎(CGN)的临床效果.方法:选取 2023 年 1-12 月上饶市立医院肾内科收治的80 例CGN患者为研究对象,通过抽签法将其分为观察组和对照组,每组 40 例.对照组给予恩格列净治疗,观察组在对照组基础上加用缬沙坦.比较两组临床疗效、治疗前后肾功能指标[血肌酐(Scr)、血尿素氮(BUN)、血清白蛋白、24 h尿蛋白(24 h UP)]、免疫指标[白细胞介素-2(IL-2)、白细胞介素-4(IL-4)]及不良反应(腹胀、皮疹、低血糖、低血压、尿路感染).结果:观察组总有效率显著高于对照组,差异有统计学意义(P<0.05).治疗后,两组Scr、BUN、24 h UP均低于治疗前,且观察组均低于对照组,差异均有统计学意义(P<0.05).治疗后,两组血清白蛋白、IL-2、IL-4 均高于治疗前,且观察组均高于对照组,差异均有统计学意义(P<0.05).两组不良反应总发生率比较,差异无统计学意义(P>0.05).结论:缬沙坦联合恩格列净治疗CGN的效果确切,能明显改善肾小球的滤过状态,使其有效排出Scr、BUN,防止蛋白质通过尿液流失,调节免疫功能,且安全性可.
Effect of ARB Combined with SGLT2 Inhibitor in the Treatment of Chronic Glomerulonephritis
Objective:To investigate the clinical effect of angiotensin Ⅱ receptor blocker(ARB)combined with sodium-glucose cotransporter 2(SGLT2)inhibitor in the treatment of chronic glomerulonephritis(CGN).Method:From January to December 2023,80 patients with CGN who were admitted to Department of Nephrology,Shangrao Municipal Hospital were selected as the research subjects,and they were divided into observation group and control group by draw lots,with 40 cases in each group.The control group was treated with Empagliflozin,and the observation group was treated with Valsartan on the basis of the control group.The clinical efficacy,before and after treatment of renal function indexes[serum creatinine(Scr),blood urea nitrogen(BUN),serum albumin,24 h urinary protein(24 h UP)]and immune indexes[interleukin-2(IL-2),interleukin-4(IL-4)],and adverse reactions(abdominal bloating,exanthem,hypoglycemia,hypotension,urinary tract infection)were compared between the two groups.Result:The total effective rate of the observation group was significantly higher than that of the control group,the difference was statistically significant(P<0.05).After treatment,Scr,BUN,24 h UP in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).After treatment,serum albumin,IL-2 and IL-4 in both groups were higher than those before treatment,and those in observation group were higher than those in control group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Valsartan combined with Empagliflozin in the treatment of CGN has a precise effect,which can significantly improve the filtration state of renal glomerulus,effectively discharge Scr and BUN,prevent protein loss through urine,regulate immune function,and is safe.
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