摘要
该研究共纳入269例不伴糖尿病慢性肾脏病(chronic kidney disease,CKD)患者为研究对象,其中对照组常规给予最大耐受剂量的肾素⁃血管紧张素⁃醛固酮系统抑制剂,175例(65.1%);达格列净组在对照组基础上给予口服达格列净10 mg/d,94例(34.9%)。结果显示,达格列净组在随访3、6、12、18、24个月时尿蛋白量均低于对照组(均P<0.05),且随访18、24个月时血清白蛋白水平均高于对照组(均P<0.05)。Kaplan⁃Meier生存曲线分析结果显示,达格列净组肾脏累积生存率明显高于对照组(Log⁃rank检验,χ^(2)=5.078,P=0.024)。多因素Cox回归分析结果显示,使用达格列净与不伴糖尿病CKD患者复合终点事件降低独立相关(HR=0.400,95%CI 0.163~0.983,P=0.046)。两组患者间各不良反应差异均无统计学意义(均P>0.05)。该研究提示达格列净具有独立于降糖作用的肾脏保护作用,且安全性较好。
A total of 269 non-diabetic chronic kidney disease(CKD)patients were enrolled in this study.Among them,175 patients(65.1%)were assigned to the control group and received conventional therapy with maximally tolerated doses of renin-angiotensin-aldosterone system inhibitors,while 94 patients(34.9%)were assigned to the dapagliflozin group and received oral dapagliflozin 10 mg/day in addition to the conventional therapy.The results showed that the urine protein quantity in the dapagliflozin group was lower than those in the control group at 3,6,12,18,and 24 months of follow-up(all P<0.05),and the blood albumin level was higher than those in the control group at 18 and 24 months of follow-up(all P<0.05).The Kaplan-Meier survival curve analysis results showed that the cumulative renal survival rate of the dapagliflozin group was significantly higher than that of the control group(Log-rank test,χ^(2)=5.078,P=0.024).Multivariable Cox regression analysis results revealed that using dapagliflozin was independently associated with a reduced risk of the composite endpoint in non-diabetic CKD patients(HR=0.400,95%CI 0.163-0.983,P=0.046).There was no statistical difference in adverse reactions between the two groups(all P>0.05).It is indicated that dapagliflozin has a renal protective effect independent of hypoglycemic action and good safety.
作者
冯玉华
窦婧予
张臻
文璐
李倩倩
苏艳
程根阳
Feng Yuhua;Dou Jingyu;Zhang Zhen;Wen Lu;Li Qianqian;Su Yan;Cheng Genyang(Department of Nephrology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Nephrology,Xinyang People's Hospital,Xinyang 464000,China)
出处
《中华肾脏病杂志》
北大核心
2025年第11期855-858,共4页
Chinese Journal of Nephrology
基金
国家自然科学基金(82300801)
河南省科技攻关项目(232102311021)。
