目的 观察卡格列净片联合利格列汀片治疗早期2型糖尿病肾病的临床疗效。方法 选择2020年5月—2020年10月就诊于天津市第二医院的86例早期2型糖尿病肾病患者，采用随机数字表法将所有患者分为对照组和治疗组，每组各43例。对照组早餐前口服利格列汀片，5 mg/次，1次/d；治疗组在对照组治疗的基础上早餐前口服卡格列净片，100 mg/次，1 次/d。两组患者均治疗16周。观察两组的临床疗效，同时比较两组治疗前后血糖、糖化血红蛋白（HbA1c）、血清胱抑素C（Cys-C）、尿β₂-微球蛋白（β₂-MG）、尿白蛋白肌酐比值（UACR）、尿白蛋白排泄率（UAER）变化。结果 治疗后，对照组和治疗组总有效率分别为72.09%、88.37%，两组总有效率比较差异有统计学意义（P<0.05）。治疗后，两组患者空腹血糖（FPG）、餐后2小时血糖（2 h PG）、HbA1c水平均较治疗前明显下降，差异均有统计学意义（P<0.05），治疗组患者FPG、2 h PG、HbA1c水平较对照组下降更明显（P<0.05）。治疗后，两组患者胱抑素C（Cys-C）、β₂-MG、UACR、UAER水平均下降，差异有统计学意义（P<0.05），且治疗组患者Cys-C、β₂-MG、UACR、UAER水平较对照组下降更明显（P<0.05）。结论 卡格列净片联合利格列汀片治疗早期2型糖尿病肾病具有较好的临床疗效，可有效降糖、减少尿蛋白。

Objective To observe the efficacy of Canagliflozin Tablets combined with Linagliptin Tablets in treatment of early type 2 diabetic nephropathy. Methods Patients (86 cases) with early type 2 diabetic nephropathy in Tianjin Second Hospital from May 2020 to October 2020 were randomly divided into control and treatment groups, and each group had 43 cases. Patients in the control group were po administered with Linagliptin Tablets before breakfast, 100 mg/time, once daily. Patients in the treatment group were po administered with Canagliflozin Tablets on the basis of the control group before breakfast, 100 mg/time, once daily. Patients in two groups were treated for 16 weeks. After treatment, the clinical efficacies were evaluated, and the blood glucose, HbA1c, Cys-C, β₂-MG, UACR, and UAER in two groups were compared. Results After treatment, the total effective rates of the control and treatment group were 72.09% and 88.37%, respectively, and the difference was statistically significant (P<0.05). After treatment, the levels of FPG, 2 h PG and HbA1c in two groups were significantly lower than those before treatment (P<0.05). And the levels of FPG, 2 h PG, and HbA1c in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the levels of Cys-C, β₂-MG, UACR, and UAER in two groups were decreased, and the difference was statistically significant (P<0.05), and the levels of Cys-C, β₂-MG, UACR, and UAER in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Canagliflozin Tablets combined with Linagliptin Tablets has a significant clinical effect in treatment of early type 2 diabetic nephropathy, can effectively reduce blood sugar and urinary protein.

R973

国家自然科学基金资助项目（81703454）