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目的:探讨卡格列净对糖尿病肾病患者尿蛋白及相关指标的影响。方法:选取2018年1月至2019年11月海南省人民医院收治的2型糖尿病肾病患者60例为研究对象，使用常规降糖治疗及血管紧张素I转化酶抑制剂（ACEI）或血管紧张素Ⅱ受体拮抗剂，剂量稳定至少2个月以上，且尿微量白蛋白肌酐比（ACR）>30 mg/g；肾小球滤过率（eGFR）≥30 mL·minn －1·1.73 mn －2、6.5%≤糖化血红蛋白（HbA1c）≤12.0%，均予以卡格列净口服，每次100 mg，每天1次；所有患者接受卡格列净治疗24周。比较患者经卡格列净治疗24周后，ACR、24 h尿蛋白定量（24 h Up）和HbA1c等指标的变化及治疗前后血压、血尿酸、血脂等的变化。n 结果:与卡格列净治疗前的24 h尿蛋白（1.01±0.56）g、ACR（667.5±157.2）mg/g、eGFR（62.9±15.0）mL·minn －1·1.73 mn －2、空腹血糖（10.0±2.3）mmol/L、HbA1c（9.5±1.3）%、收缩压（141.41±5.42）mmHg、尿酸（456.29±26.65）μmol/L相比，经卡格列净治疗24周后的24 h尿蛋白（0.66±0.37）g、ACR（350.3±274.7）mg/g、eGFR（75.2±19.3）mL·minn －1·1.73 mn －2、空腹血糖（FPG）（8.04±1.71）mmol/L、HbA1c（8.6±1.2）%、收缩压（128.38±5.20）mmHg、尿酸（367.98±46.37）μmol/L，均差异有统计学意义（n t=11.63、4.25、－2.80、4.10、3.60、5.90、2.70，n P=0.000、0.036、0.023、0.016、0.028、0.001、0.042）。n 结论:卡格列净除有良好的降血糖效果外，能改善糖尿病肾病患者的尿蛋白及肾功能，同时还具有降血压和降尿酸的作用。“,”Objective:To investigate the effect of canagliflozin on urinary protein and related indicators in patients with diabetic nephropathy.Methods:Sixty patients with type 2 diabetic nephropathy who received treatment in Hainan General Hospital from January 2018 to November 2019 were included in this study. They were treated with conventional hypoglycemic therapy and angiotensin I converting enzyme inhibitor (ACEI) or angiotensin II receptor antagonist at stable dosage for at least 2 months, with urinary albumin creatinine ratio (ACR) > 30 mg/g, estimated glomerular filtration rate (eGFR) ≥ 30 mL/min·1.73/m n 2,6.5% ≤ HbA1c ≤ 12.0%. All patients were orally administered canagliflozin, 100 mg once daily, for 24 successive weeks. ACR, 24-hour urine protein, HbA1c, blood pressure, blood uric acid and blood lipid levels were compared before and 24 hours after treatment with canagliflozin.n Results:There were significant differences in urine protein [(1.01 ± 0.56) gn vs. (0.66 ± 0.37) g, n t = 11.63, n P = 0.000], ACR [(667.5 ± 157.2) mg/g n vs. (350.3 ± 274.7) mg/g, n t = 4.25, n P = 0.036], eGFR [(62.9 ± 15.0) mL/min·1.73/mn 2vs. (75.2 ± 19.3) mL/min·1.73/mn 2 , n t = -2.80, n P = 0.023], fasting blood glucose [(10.0 ± 2.3) mmol/Ln vs. (8.04 ± 1.71) mmol/L, n t = 4.10, n P = 0.016], HbA1c [(9.5 ± 1.3)% n vs. (8.6 ± 1.2)%, n t = 3.60, n P = 0.028], systolic blood pressure [(141.41 ± 5.42) mmHg n vs.(128.38 ± 5.20) mmHg, n t = 5.90, n P = 0.001], and uric acid [(456.29 ± 26.65)μmol/L n vs. (367.98 ± 46.37) μmol/L, n t = 2.70,n P = 0.042] between before and after 24 hours of canagliflozin treatment.n Conclusion:In addition to good hypoglycemic effect,canagliflozin can lower urine protein level,improve renal function, and decrease blood pressure and uric acid level in patients with diabetic nephropathy.