2026 年第 9 期 第 21 卷

非奈利酮联合普罗碘铵治疗糖尿病肾病的效果及对炎性因子和氧化应激的作用机制研究

Efficacy of finerenone combined with prolonium iodide in the treatment of diabetic nephropathy and its mechanism on inflammatory factors and oxidative stress

作者：曹仁芳曲建梅张毅飞王丹王晓梅

英文作者：Cao Renfang Qu Jianmei Zhang Yifei Wang Dan Wang Xiaomei

单位：大连大学附属中山医院内分泌科，大连116001

英文单位：Department of Endocrinology Affiliated Zhongshan Hospital of Dalian University Dalian 116001 China

关键词：糖尿病肾病；非奈利酮；普罗碘铵；炎性因子；氧化应激；肾功能

英文关键词：Diabeticnephropathy;Finerenone;Proloniumiodide;Inflammatoryfactors;Oxidativestress;Renalfunction

• 摘要：

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  目的 探讨非奈利酮联合普罗碘铵治疗糖尿病肾病(DN）的临床效果，并分析其对炎性因子、氧化应激及纤维化指标的影响。方法 选取2023年6月至2025年6月大连大学附属中山医院收治的120例DN患者为研究对象。采用随机数字表法将患者分为非奈利酮组和联合组，各60例。非奈利酮组在基础治疗基础上给予非奈利酮治疗，联合组在非奈利酮组基础上加用普罗碘铵治疗，2组患者均治疗6个月。比较2组患者治疗前后的肾功能指标、血清炎症因子指标、氧化应激指标、血清纤维化指标及不良反应发生情况。结果 治疗后，2组估算肾小球滤过率、超氧化物歧化酶水平均高于治疗前，且联合组均高于非奈利酮组，差异均有统计学意义（均P＜0.05）。治疗后，2组24 h尿蛋白定量、尿白蛋白/肌酐比值、尿微量白蛋白、血肌酐、血尿素氮、白细胞介素6、高敏C反应蛋白、丙二醛、结缔组织生长因子、转化生长因子β1、Ⅳ型胶原、Ⅲ型前胶原水平均低于治疗前，且联合组24 h尿蛋白定量、尿白蛋白/肌酐比值、尿微量白蛋白、血肌酐、白细胞介素6、高敏C反应蛋白、丙二醛、结缔组织生长因子、转化生长因子β1、Ⅳ型胶原水平均低于非奈利酮组，差异均有统计学意义（均P＜0.05）。联合组与非奈利酮组不良反应发生率比较［16.7%（10/60）比11.7%（7/60）］差异无统计学意义（χ2=0.617，P=0.432）。结论 非奈利酮联合普罗碘铵治疗DN可有效抑制炎症反应、改善氧化应激失衡、延缓肾脏纤维化进程，改善患者的肾功能，且安全性良好。

• Objective To investigate the clinical efficacy of finerenone combined with prolonium iodide in the treatment of diabetic nephropathy (DN), and analyze its effects on inflammatory factors, oxidative stress and fibrosis indicators. Methods A total of 120 patients with DN admitted to Affiliated Zhongshan Hospital of Dalian University from June 2023 to June 2025 were selected as research subjects. The patients were divided into finerenone group and combination group by random number table method, with 60 cases in each group. The finerenone group was treated with finerenone on the basis of basic treatment, while the combination group was additionally treated with prolonium iodide on the basis of the finerenone group. Both groups were treated for 6 months. Renal function indicators, serum inflammatory factors, oxidative stress indicators, serum fibrosis indicators and adverse reactions were compared between the two groups before and after treatment. Results After treatment, estimated glomerular filtration rate and superoxide dismutase levels in both groups were higher than those before treatment, and those in the combination group were higher than those in the finerenone group (all P＜0.05). After treatment, 24 h urinary protein quantification, urinary albumin-creatinine ratio, urinary microalbumin, serum creatinine, blood urea nitrogen, interleukin-6, high-sensitivity C-reactive protein, malondialdehyde, connective tissue growth factor, transforming growth factor-β1, type Ⅳ collagen and type Ⅲ procollagen levels in both groups were lower than those before treatment. Moreover, 24 h urinary protein quantification, urinary albumin-creatinine ratio, urinary microalbumin, serum creatinine, interleukin-6, high-sensitivity C-reactive protein, malondialdehyde, connective tissue growth factor, transforming growth factor-β1 and type Ⅳ collagen levels in the combination group were lower than those in the finerenone group (all P＜0.05). There was no statistically significant difference in the incidence of adverse reactions between the combination group and the finerenone group ［16.7%(10/60) vs 11.7%(7/60)］(χ2=0.617, P=0.432). Conclusion Finerenone combined with prolonium iodide can effectively inhibit inflammatory response, improve oxidative stress imbalance, delay the progression of renal fibrosis, ameliorate renal function in patients with DN, and has good safety.