达格列净对慢性肾病患者代谢与心血管系统影响的研究OA

Objective To evaluate the effects of dapagliflozin tablets on metabolic and cardiovascular system in patients with chronic kidney disease(CKD).Methods CKD patients hospitalized in our institution who underwent coronary computed tomography angiography(CCTA)were divided into dapagliflozin group and non-dapagliflozin group according to treatment regimens.Levels of uric acid,creatinine,uric acid reduction rate,creatinine reduction rate and coronary artery calcium score(CACS)were compared between the two groups.Univariate and multivariate logistic regression analyses were performed to assess the independent risk factors of dapagliflozin on coronary artery calcification(CAC).Results A total of 30 cases were included in dapagliflozin group,60 cases were included in non-dapagliflozin group.After treatment,uric acid levels were(182.31±52.56)and(221.75±73.45)μmol·L-1,creatinine levels were(49.27±15.33)and(55.20±16.43)μmol·L-1,CACS were 0(0,0)and 0(0,28.93)points,uric acid reduction rates were(46.34±7.45)％and(25.81±4.56)％,creatinine reduction rates were(27.23±5.53)％and(9.12±2.46)％,and CAC incidence rates were 3.33％and 20.00％in the dapagliflozin group and non-dapagliflozin group,respectively.All the above indicators showed statistically significant differences between the two groups(all P＜0.05).Multivariate logistic regression analysis showed that,after adjusting for confounding factors including sex,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),uric acid,total cholesterol,low-density lipoprotein cholesterol(LDL-C)and glycated hemoglobin(HbA1c),dapagliflozin remained an independent protective factor against CAC(OR=0.128,95％CI:0.03-0.62,P＜0.05).The main adverse drug reactions of dapagliflozin group were mild genitourinary infection and postural hypotension;hypoglycemia and urinary tract infection were the main adverse drug reaction in non-dapagliflozin group.The total incidence of adverse drug reactions in dapagliflozin group and non-dapagliflozin group were 10.00％and 6.67％,respectively,with no significant difference in statistics(P＞0.05),demonstrating good safety profile.Conclusion Dapagliflozin tablets can significantly reduce uric acid,creatinine and CACS levels in CKD patients,and may serve as a potential protective factor against coronary artery calcification.