西格列汀对初诊2型糖尿病并发早期糖尿病肾病患者的影响  

The effect of sitagliptin on type 2 diabetes mellitus complicated with early diabetic kidney disease(DKD) patients

作　　者：郝清顺[1] 刘玉苓[1] 费大东[1] 

机构地区：[1]枣庄市立医院内分泌科,山东枣庄277100

出　　处：《泰山医学院学报》2015年第9期989-991,共3页Journal of Taishan Medical College

摘　　要：目的观察西格列汀对初诊2型糖尿病(T2DM)并发早期糖尿病肾病(DKD)患者的临床疗效。方法选取初诊T2DM并发早期DKD患者64例,随机分为对照组30例,实验组34例,对照组给予阿卡波糖联合二甲双胍治疗,实验组给予西格列汀联合二甲双胍及阿卡波糖治疗,维持治疗6个月,观察治疗前后空腹血糖(FBG)、糖化血红蛋白(Hb A1c)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白-胆固醇(LDL-C)、收缩压(SBP)、舒张压(DBP)、尿微量白蛋白/肌酐(UACR)、尿α1-微球蛋白(MG)、肾小球滤过率(e GFR)的变化。结果与治疗前比较,对照组治疗后FBG、Hb A1c显著下降,差异有统计学意义(P<0.01),TG、TC、LDL-C亦下降,有统计学差异(P<0.05)。实验组治疗后BMI、SBP、α1-MG、e GFR较治疗前下降,有统计学意义(P<0.05),而FBG、Hb A1c、TG、TC、LDL-C、UACR较治疗前下降明显,有统计学差异(P<0.01)。两组治疗后TC、UACR有显著差异,有统计学意义(P<0.05)。结论西格列汀不仅有效平稳控制早期糖尿病肾病患者血糖,还可以减少尿蛋白漏出,延缓早期糖尿病肾病的发展。Objective：To observe the clinical efficacy of sitagliptin for newly diagnosed type 2 diabetic complicated with early diabetic kidney disease（ DKD）patients. Methods：The newly diagnosed 64 cases T2DM patients complicated with early DKD were selecred and randomly divided into the 30 cases in the control group,and 34 cases in experimental group, with the control group given acarbose in combination with metformin treatment,and experimental group given sitagliptin in combination with metformin treatment and the treatment was for six months,and observation of fasting blood glucose （FBG）,glycosylated hemoglobin（HbA1c）,triglycerides（TG）,total cholesterol（TC）,low density lipoprotein choles-terol（ LDL-C ）, systolic blood pressure （ SBP ）, diastolic blood pressure （ DBP ）, urine trace albumin/creatinine （ UACR）,urine alpha 1-microglobulin（ MG）,and the changes of glomerular filtration rate（ eGFR）were made before and after treatment. Results：Compared with those before the treatment,there was a significant reduction of FBG,HbA1c in the control group after treatment,the difference was statistically significant（P﹤0. 01）,TG,TC,LDL-C also fell,and there are statistically significant（P﹤0. 05）. BMI and SBP were down after experimental treatment,compared with those before treatment（P﹤ 0. 05）,while FBG,HbA1c,TG,TC,LDL-C,UACR were down significantly,compared with those be-fore treatment and difference was statistically significant（P﹤0. 01）. TC and UACR had significant difference between the two groups after treating and hsd statistical significance（P﹤ 0. 05）. Conclusion：Sitagliptin not only effectively control blood sugar of early diabetic nephropathy,but also can reduce urine protein leakage,which delays the development of early diabetic nephropathy.

关 键 词：西格列汀 初诊2型糖尿病 早期糖尿病肾病 

分 类 号：R587.2[医药卫生—内分泌]