2023 年第 11 期 第 18 卷

2型糖尿病或糖尿病肾病患者应用达格列净片治疗后短期尿液生化指标改变研究

Study on short-term changes of urine biochemical indicators in patients with type 2 diabetes mellitus or diabetic nephropathy after treatment with dapagliflozin tablets

作者：白嘉嘉陈琪陈振杰李梦笔王珍吕杰陈玮鸿刘晴晴刘忠杰李岩周静威

英文作者：Bai Jiajia Chen Qi Chen Zhenjie Li Mengbi Wang Zhen Lyu Jie Chen Weihong Liu Qingqing Liu Zhongjie Li Yan Zhou Jingwei

单位：北京中医药大学东直门医院肾病内分泌科一区，北京100700

英文单位：First Division Department of Nephrology & Endocrinology Dongzhimen Hospital Beijing University of Chinese Medicine Beijing 100700 China

关键词：2型糖尿病；糖尿病肾病；达格列净；尿液生化

英文关键词：Type2diabetesmellitus;Diabeticnephropathy;Dapagliflozin;Urinebiochemistry

• 摘要：

• 目的  观察2型糖尿病（T2DM）或糖尿病肾病（DN）患者应用达格列净片治疗后短期尿液生化指标改变。方法  选择2020年10月至2021年12月于北京中医药大学东直门医院住院的40例T2DM或DN患者。在接受糖尿病及DN标准化治疗的背景下，测定患者口服达格列净片1周后，尿液生化指标的前后变化。结果  治疗1周后，全部患者24 h尿钠、尿氯排泄、尿液阴离子间隙（UAG）及尿尿酸排泄水平显著高于治疗前［（193±57）mmol/24 h比（156±49）mmol/24 h、（170±51）mmol/L比（139±44）mmol/L、（65±22）mmol/L比（55±20）mmol/L、（3 039±1 233）μmol/24 h比（1 540±1 053）μmol/24 h］，24 h尿肌酐排泄水平显著低于治疗前［（4 436±1 540）μmol/L比（5 378±2 366）μmol/L］，差异均有统计学意义（均P＜0.05）；单纯T2DM患者24 h尿钠、尿氯排泄、尿尿酸排泄水平显著高于治疗前［（189±31）mmol/24 h比（136±14）mmol/24 h、（169±29）mmol/L比（122±20）mmol/L、（3 447±1 223）μmol/24 h比（2 757±1 129）μmol/24 h］，差异均有统计学意义（均P＜0.05）；DN患者24 h尿钠、尿氯排泄水平显著高于治疗前［（196±70）mmol/24 h比（170±60）mmol/24 h、（171±63）mmol/L比（151±52）mmol/L］，24 h尿肌酐排泄水平显著低于治疗前［（4 412±1 303）μmol/L比（5 674±2 618）μmol/L］，差异均有统计学意义（均P＜0.05）；单纯T2DM患者和DN患者24 h尿蛋白定量与治疗前比较差异均无统计学意义（均P＞0.05）。结论  应用达格列净短期可改善患者尿液离子代谢排泄。

• Objective  To observe the short-term changes of urine biochemical indicators in patients with type 2 diabetes mellitus (T2DM) or diabetic nephropathy (DN) after treatment with dapagliflozin tablets. Methods  Totally 40 patients with T2DM or DN admitted to Dongzhimen Hospital, Beijing University of Chinese Medicine from October 2020 to December 2021 were enrolled. Under the background of receiving standardized treatment for diabetes mellitus and DN, the changes of urine biochemical indicators were measured before and after 1 week treatment with dapagliflozin tablets. Results  After 1 week of treatment, 24 h urinary sodium, urinary chloride excretion, urinary anion gap(UAG), and uric acid excretion in all patients were significantly higher than those before treatment［(193±57)mmol/24 h vs (156±49)mmol/24 h, (170±51)mmol/L vs (139±44)mmol/L, (65±22)mmol/L vs (55±20)mmol/L, (3 039±1 233)μmol/24 h vs (1 540±1 053)μmol/24 h］, the 24 h urinary creatinine excretion level was significantly lower than that before treatment［(4 436±1 540)μmol/L vs (5 378±2 366)μmol/L］(all P<0.05); the levels of urinary sodium, urinary chloride excretion, and urinary acid excretion in pure T2DM patients at 24 h were significantly higher than those before treatment［(189±31)mmol/24 h vs (136±14)mmol/24 h, (169±29)mmol/L vs (122±20)mmol/L, (3 447±1 223)μmol/24 h vs (2 757±1 129)μmol/24 h］, the differences were statistically significant(all P<0.05); the 24 h urinary sodium and chloride excretion levels in DN patients were significantly higher than those before treatment［(196±70)mmol/24 h vs (170±60)mmol/24 h, (171±63)mmol/L vs (151±52)mmol/L］, and the 24 h urinary creatinine excretion level was lower than that before treatment［(4 412±1 303)μmol/L vs (5 674±2 618)μmol/L］(all P<0.05); there were no statistically significant differences in 24 h urine protein quantification in T2DM patients and DN patients compared to before treatment(both P>0.05). Conclusion  The application of dapagliflozin can improve patients′ urinary ion metabolism and excretion in the short-term.