目的 探討非奈利酮聯(lián)合恩格列凈治療早中期糖尿病腎病的臨床療效。方法 選取2023年1月—2024年2月復(fù)旦大學(xué)附屬中山醫(yī)院青浦分院收治的68例早中期糖尿病腎病患者，依據(jù)隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各34例。對(duì)照組口服恩格列凈片，10 mg/次，1次/d，同時(shí)口服厄貝沙坦片，0.15 g/次，1次/d。治療組口服恩格列凈片，10 mg/次，1次/d，同時(shí)口服非奈利酮片，10～20 mg/d，持續(xù)服用4周后，20 mg/d。兩組患者均治療3個(gè)月。觀察兩組患者臨床療效，比較治療前后兩組患者空腹血糖（FBG）、餐后2 h血糖（2 h PG）、糖化血紅蛋白（HbA1c）、降鈣素原（PCT）、白細(xì)胞計(jì)數(shù)（WBC）、C反應(yīng)蛋白（CRP）、白細(xì)胞介素-6（IL-6）、24 h尿蛋白定量（24 h UP）、尿微量白蛋白/尿肌酐（ACR）、尿素氮（BUN）、血肌酐（Scr）和估算的腎小球?yàn)V過率（eGFR）水平。結(jié)果 治療后，對(duì)照組和治療組患者總有效率分別為76.47%和97.06%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，兩組患者FBG、2 h PG、HbA1c、PCT、WBC、CRP、IL-6、24 h UP、ACR、BUN和Scr水平比治療前明顯降低，而eGFR水平明顯升高（P＜0.05），且治療組患者這些指標(biāo)水平較治療前降低更顯著（P＜0.05）。結(jié)論 非奈利酮聯(lián)合恩格列凈治療早中期糖尿病腎病患者的效果更好，能減輕炎癥反應(yīng)，改善腎功能。

Objective To explore the effect of finerenone combined with empagliflozin in treatment of early and middle stage diabetes nephropathy. Methods Patients (68 cases) with early and middle stage diabetes nephropathy in Qingpu Branch, Zhongshan Hospital Affiliated to Fudan University from January 2023 to February 2024 were divided into control and treatment group according to random number table method, and each group had 34 cases. Patients in the control group were po administered with Empagliflozin Tablets, 10 mg/time, once daily, and at the same time they were po administered with Irbesartan Tablets, 0.15 g/time, once daily. Patients in the treatment group were po administered with Empagliflozin Tablets, 10 mg/time, once daily, and at the same time they were po administered with Finerenone Tablets, 10 — 20 mg/d for 4 weeks, then 20 mg/d. Patients in two groups were treated for 3 months. After treatment, the clinical evaluations were evaluated, the levels of FBG, 2 h PG, HbA1c, PCT, WBC, CRP, IL-6, 24 h UP, ACR, BUN and Scr in two groups before and after treatment were compared. Results After treatment, the total clinical effective rates of patients in the control group and treatment group were 76.47% and 97.06%, respectively, and the difference was statistically significant between two groups (P < 0.05). After treatment, the levels of FBG, 2 h PG, HbA1c, PCT, WBC, CRP, IL-6, 24h UP, ACR, BUN, and Scr in two groups were significantly lower than before treatment, while the eGFR level was significantly higher (P < 0.05), and the levels of these indicators in the treatment group decreased more significantly than before treatment (P < 0.05). Conclusion Finerenone combined with empagliflozin has a better effect in treating patients with early and mid-stage diabetic nephropathy, which can reduce inflammatory response and improve renal function.

R977

上海市青浦區(qū)衛(wèi)生健康系統(tǒng)第五輪學(xué)科建設(shè)和人才培養(yǎng)項(xiàng)目(TX2023-26);青浦區(qū)科技發(fā)展基金項(xiàng)目(QKY2021-05)