摘要
目的探讨达格列净对冠心病(CHD)合并2型糖尿病(T2DM)伴轻、中度肾功能不全患者经皮冠状动脉介入术(PCI)治疗后肾功能的影响。方法将60名CHD合并T2DM伴轻、中度肾功能不全行PCI术后患者随机分为干预组和对照组,每组30例。对照组采用常规治疗,干预组在常规治疗的基础上口服达格列净。比较两组患者的血肌酐、血尿素氮(BUN)、肌酐清除率(CCR)、估算肾小球滤过率(eGFR),以及血清超氧化物歧化酶(SOD)、丙二醛(MDA)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平,并观察治疗期间对比剂肾病(CIN)发生情况。结果术后72 h,两组患者血肌酐、BUN较术前升高,但干预组上述指标水平低于对照组(P<0.05);两组患者CCR、eGFR较术前降低,但干预组高于对照组(P<0.05)。术后72 h,两组患者血清SOD、MDA、IL-6、TNF-α水平较术前升高,但干预组患者的上述指标水平低于对照组(P<0.05)。结论达格列净对冠心病合并T2DM伴轻、中度肾功能不全患者PCI术后的肾功能具有一定的改善作用,其可能是通过降低患者炎症因子水平和氧化应激发挥作用。
Objectives To investigate the effects of dapagliflozin on renal function in patients with coronary heart disease(CHD)complicated with diabetes mellitus type 2(T2DM)and mild-to-moderate renal insufficiency following percutaneous coronary intervention(PCI).Methods A total of 60 patients with CHD complicated with T2DM and mild-to-moderate renal insufficiency who underwent PCI were randomly divided into an intervention group and a control group,with 30 cases in each group.The control group received conventional treatment,whereas the intervention group received oral dapagliflozin in addition to conventional treatment.The following parameters were compared between the two groups:serum creatinine,blood urea nitrogen(BUN),creatinine clearance rate(CCR),estimated glomerular filtration rate(eGFR),and serum superoxide dismu-tase(SOD),malondialdehyde(MDA),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)levels.The occurrence of contrast induced nephropathy(CIN)during the treatment period was also observed.Results At 72 hours postoperatively,both groups exhibited elevated serum creatinine and BUN levels compared with preoperative levels,with the intervention group demonstrating significantly lower levels than the control group(P<0.05).Both groups showed decreased CCR and eGFR compared with preoperative levels,with the intervention group exhibiting significantly higher levels than the control group(P<0.05).At 72 hours postoperatively,both groups demonstrated elevated levels of serum SOD,MDA,IL-6,and TNF-αcompared with preoperative levels,with the intervention group showing significantly lower levels of these biomarkers than the control group(P<0.05).Conclusion Dapagliflozin exerts an improving effect on renal function in patients with CHD complicated with T2DM and mild-to-moderate renal insufficiency following PCI.This improving effect may exert its action through reducing levels of inflammatory cytokines and alleviating oxidative stress.
作者
邓国雄
古姚杰
唐泉
黄允业
谈金月
韦金儒
刘杰
DENG Guoxiong;GU Yaojie;TANG Quan;HUANG Yunye;TAN Jinyue;WEI Jinru;LIU Jie(Department of Cardiology,the First People's Hospital of Nanning,Nanning 530021,Guangxi,China;Department of Cardiology,Fangchenggang Hospital of Traditional Chinese Medicine,Fangchenggang 538000,Guangxi,China)
出处
《微创医学》
2025年第3期309-314,共6页
Journal of Minimally Invasive Medicine
基金
广西壮族自治区卫生健康委员会自筹经费科研课题(编号:Z20201226)。
关键词
达格列净
冠心病
经皮冠状动脉介入治疗
肾功能
对比剂肾病
炎症因子
Dapagliflozin
Coronary heart disease
Percutaneous coronary intervention
Renal function
Contrast-induced nephropathy
Inflammatory factors
