目的 觀察卡格列凈片聯(lián)合利格列汀片治療早期2型糖尿病腎病的臨床療效。方法 選擇2020年5月—2020年10月就診于天津市第二醫(yī)院的86例早期2型糖尿病腎病患者，采用隨機數(shù)字表法將所有患者分為對照組和治療組，每組各43例。對照組早餐前口服利格列汀片，5 mg/次，1次/d；治療組在對照組治療的基礎(chǔ)上早餐前口服卡格列凈片，100 mg/次，1 次/d。兩組患者均治療16周。觀察兩組的臨床療效，同時比較兩組治療前后血糖、糖化血紅蛋白（HbA1c）、血清胱抑素C（Cys-C）、尿β₂-微球蛋白（β₂-MG）、尿白蛋白肌酐比值（UACR）、尿白蛋白排泄率（UAER）變化。結(jié)果 治療后，對照組和治療組總有效率分別為72.09%、88.37%，兩組總有效率比較差異有統(tǒng)計學意義（P<0.05）。治療后，兩組患者空腹血糖（FPG）、餐后2小時血糖（2 h PG）、HbA1c水平均較治療前明顯下降，差異均有統(tǒng)計學意義（P<0.05），治療組患者FPG、2 h PG、HbA1c水平較對照組下降更明顯（P<0.05）。治療后，兩組患者胱抑素C（Cys-C）、β₂-MG、UACR、UAER水平均下降，差異有統(tǒng)計學意義（P<0.05），且治療組患者Cys-C、β₂-MG、UACR、UAER水平較對照組下降更明顯（P<0.05）。結(jié)論 卡格列凈片聯(lián)合利格列汀片治療早期2型糖尿病腎病具有較好的臨床療效，可有效降糖、減少尿蛋白。

Objective To observe the efficacy of Canagliflozin Tablets combined with Linagliptin Tablets in treatment of early type 2 diabetic nephropathy. Methods Patients (86 cases) with early type 2 diabetic nephropathy in Tianjin Second Hospital from May 2020 to October 2020 were randomly divided into control and treatment groups, and each group had 43 cases. Patients in the control group were po administered with Linagliptin Tablets before breakfast, 100 mg/time, once daily. Patients in the treatment group were po administered with Canagliflozin Tablets on the basis of the control group before breakfast, 100 mg/time, once daily. Patients in two groups were treated for 16 weeks. After treatment, the clinical efficacies were evaluated, and the blood glucose, HbA1c, Cys-C, β₂-MG, UACR, and UAER in two groups were compared. Results After treatment, the total effective rates of the control and treatment group were 72.09% and 88.37%, respectively, and the difference was statistically significant (P<0.05). After treatment, the levels of FPG, 2 h PG and HbA1c in two groups were significantly lower than those before treatment (P<0.05). And the levels of FPG, 2 h PG, and HbA1c in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the levels of Cys-C, β₂-MG, UACR, and UAER in two groups were decreased, and the difference was statistically significant (P<0.05), and the levels of Cys-C, β₂-MG, UACR, and UAER in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Canagliflozin Tablets combined with Linagliptin Tablets has a significant clinical effect in treatment of early type 2 diabetic nephropathy, can effectively reduce blood sugar and urinary protein.

R973

國家自然科學基金資助項目（81703454）