西格列汀对2型糖尿病肾病保护作用的Meta-分析  

Meta-analysis of protective effects of sitagliptin for treatment of type 2 diabetic nephropathy

作　　者：张春燕[1] 范小冬 孔文强 谢星星 周春阳[1] 杜彪[1,4] ZHANG Chunyan;FAN Xiaodong;KONG Wenqiang;XIE Xingxing;ZHOU Chunyang;DU Biao(School of Pharmacy, North Sichuan Medical college, Nanchong 637000, China;School of Pharmacy, Southwest Medical University, Luzhou 646000, China;Department of Pharmacy, Affiliated Hospital of Southwest Medical University, Luzhou 646000, China;Department of Pharmacy, Chongqing Three Gorges Central Hospital, Chongqing 404000, China)

机构地区：[1]川北医学院药学院,四川南充637000 [2]西南医科大学药学院,四川泸州646000 [3]西南医科大学附属医院药学部,四川泸州646000 [4]重庆三峡中心医院药学部,重庆404000

出　　处：《药物评价研究》2018年第5期886-891,共6页Drug Evaluation Research

基　　金：重庆市社会事业与民生保障科技创新专项(cstc2015shmszx120073;cstc2017shmsA130105);重庆市万州科技计划基金(201403055)

摘　　要：目的系统评价二肽基肽酶-4(DPP-4)抑制剂西格列汀对中国2型糖尿病肾病患者的保护作用。方法计算机检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普数据库(VIP)、万方数据库等数据库,并追溯纳入文献的参考文献,时限为建库至2017年3月。获取西格列汀对中国2型糖尿病肾病的保护作用的随机对照试验(RCTs),采用Rev Man5.0软件对各项指标进行Meta-分析。结果共纳入12篇RCT,包括糖尿病肾病患者788例。Meta-分析结果显示:西格列汀组在降低血糖指标空腹血糖、糖化血红蛋白、餐后2 h血糖及体质量指数,和肾脏功能指标尿白蛋白肌酐比值、尿微量白蛋白、高敏C反应蛋白、胱抑素等方面均优于常规治疗对照组,差异有统计学意义(MD<0,P<0.05);在降低肌酐、尿白蛋白排泄率、β2-微球蛋白方面,两组差异无统计学意义。结论新型降血糖药物DPP-4抑制剂西格列汀不仅可以降低血糖,还可以对糖尿病肾病患者肾脏起保护作用。Objective To investigate the protective effects of sitagliptin as dipeptidyl peptidase-4（DPP-4） inhibitor on kidney in patients with type 2 diabetes mellitus. Methods The related literatures in databases were searched including CNKI, Wan Fang, VIP, CBM and so on. Randomized controlled trials（RCTs） of sitagliptin for the treatment of type 2 diabetic nephropathy were included, data were collected with time limit from establishment to March, 2017 and also retrieved manually, Meta-analysis of the data was performed by using Rve Man 5.0. Results Twelve RCTs were collected, including 788 diabetic nephropathy patients. The results of Meta-analysis showed that sitagliptin group can effectively reduce the FBG, Hb A1 c, 2 h PBG, BMI, ACR, m ALB, hs-CRP, and Cys C（MD 〈 0, P 〈 0.05） compared with the routine therapy group. There was no significant difference in index of β2-MG, Scr, and UAER between two groups. Conclusion As the new kind of hypolycemic agent, DPP-4 inhibitor sitagliptin can not only reduce the blood glucose but also protect the renal function of type 2 diabetic nephropathy patients.

关 键 词：西格列汀 糖尿病肾病 二肽基肽酶-4抑制剂 META-分析 

分 类 号：R969.4[医药卫生—药理学]