【摘要】 目的评价达格列净每日10 mg对糖尿病肾病患者尿蛋白的作用。方法 15例2型糖尿病肾病患者[尿白蛋白肌酸酐比（ACR）> 30 mg·g^-1且肾小球滤过率（e GFR）≥45 m L·min^-1·1. 73 m^-2]均予以达格列净每次10 mg,qd,口服。所有患者均治疗12周。比较患者用药前和用药后4,8,12周的尿ACR、24 h尿蛋白定量和e GFR等指标。结果 15例患者完成本研究。与用药前患者的尿ACR（754. 17±330. 70） mg·g^-1,24 h尿蛋白定量（1. 64±0. 62） g相比,治疗4,8,12周后患者的尿ACR分别下降了27. 4%,34. 6%和27. 7%,差异均有统计学意义（均P <0. 01）,24 h尿蛋白定量较基线分别下降了17. 5%,30. 9%（P <0. 01）和34. 9%（P <0. 01）。与用药前患者的e GFR（81. 63±5. 24）m L·min^-1·1. 73 m^-2相比,用药4,8和12周后e GFR分别为[（72. 47±4. 84）,P <0. 01],（75. 91±5. 28）和[（75. 62±5. 97）,P <0. 05]m L·min^-1·1. 73 m^-2。结论糖尿病肾病患者用达格列净治疗4～12周后,尿蛋白水平显著下降,e GFR在治疗4周时有轻度下降,治疗8～12周后e GFR部分恢复。更多还原

【Abstract】 Objective To evaluate the effect of dapagliflozin 10 mg·d^-1 on proteinuria in patients with diabetic kidney disease. Methods Fifteen type 2 diabetes patients with diabetic kidney disease [albumin creatinine ratio（ ACR） > 30 mg · g^-1 and estimated glomerular filtration rate（ eGFR） ≥45 m L·min^-1·1. 73 m^-2]were prescribed dapagliflozin 10 mg,qd,orally,for 12 weeks. The ACR,24-hour quantity of urine protein,eGFR were compared between baseline and 4-week,8-week,12-week after prescription respectively. Results Fifteen patients finally completed the study. Compared with baseline ACR（ 754. 17 ± 330. 70）mg·g^-1 and 24-hour quantity of urine protein（ 1. 64 ± 0. 62） g,ACR decreased 27. 4%,34. 6% and 27. 7%（ all P < 0. 01）,24-hour quantity of urine protein decreased 17. 5%,30. 9%（ P < 0. 01） and 34. 9%（ P < 0. 01） on 4-week,8-week,12-week visits,respectively.Compared with baseline eGFR（ 81. 63 ± 5. 24） m L ·min^-1·1. 73 m^-2,e GFR was [（ 72. 47 ± 4. 84）,P < 0. 01 ],（ 75. 91 ± 5. 28） and[（ 75. 62 ± 5. 97）,P < 0. 05] m L·min^-1·1. 73 m^-2 on 4-week,8-week,12-week visits,respectively. Conclusion Dapagliflozin decreased the level of proteinuria in diabetic kidney disease patients significantly after prescription for 4-12 weeks. eGFR decreased mildly on4-week visit and went back partly on 8-week,12-week visits.更多还原