西格列汀对早期2型糖尿病肾病患者肾功能的影响

目的:研究西格列汀对早期2型糖尿病肾病患者肾小球、肾小管标志性蛋白/酶的影响。方法:早期2型糖尿病肾病患者72例,随机数字表分为对照组36例、治疗组36例;两组均采用糖尿病饮食管理、运动治疗,在控制血糖、血脂、血压的基础上,治疗组给予磷酸西格列汀100 mg 1粒/次,1次/天,持续服药6月。观察治疗前、后两组血肌酐(Scr)、尿素氮(BUN)、糖化血红蛋白(Hb A1c)、血脂、空腹血糖(FBG)、餐后2小时血糖(2 h PBG)、血清胱抑素-C(Cys-C)及24 h尿微量白蛋白(24 h UAE)、尿N-乙酰-β-氨基葡萄糖苷酶(NAG)、尿β2-微球蛋白(β2-MG)的变化。结果:治疗后,治疗组血脂、Hb A1c、FBG、2 h PBG较对照组明显下降,差异有显著性(P0.05)。两组患者24 h UAE、NAG、β2-MG和Cys-C较治疗前均下降,差异有显著性(P0.05);两组治疗后相比,差异具有统计学意义(P0.05)。结论:西格列汀可以有效控制早期DN患者的血糖水平,减少血清Cys-C、尿微量白蛋白水平,减轻肾小管损伤,有利于延缓DN的病程和进展。

Effects of Sitagliptin on Renal Function in Patients with Early Type 2 Diabetic Nephropathy

Objective:To investigate the effects of Sitagliptin on glomerular and tubular iconic protein/enzyme in patients with early type 2 diabetic nephropathy.Methods:Seventy-two patients with early type 2 diabetic nephropathy were randomly divided into treatment group (n=36) and control group (n=36). Both groups adopted the diabetic diet, exercise programs. On the base of their blood glucose, lipids and blood pressure control, patients in the treatment group were treated with Sitagliptin 100 mg per day, while patients in the control group received placebo. The levels of serumcreatinine (Scr), blood urea nitrogen (BUN), glycosylated hemoglobin(HbA1c), lipids, fasting blood glucose(FBG), 2 -hour postprandial blood glucose(2 h PBG), blood Cystatin C(Cys-C), and 24-hour urinary albumin excretion (24 h UAE), N-acetyl- beta-D-amino-glucosidase (NAG), beta2-microglobulin (beta2 -MG) before and after the treatment were determined and compared.Results:After treatment, the levels of lipids, HbA1c, FBG and 2 h PBG in Sitagliptin treatment group were significantly lower than those of the control group (P<0.05), 24 h UAE, NAG, beta2-MG and Cys-C were significantly decreased in two group patients after treatment (P<0.05), and it was decreased more significantly in the treatment group than that of control group (P<0. 05).Conclusion:Sitagliptin can effectively control the blood glucose, decrease the levels of blood Cys-C and urinary albumin excretion, reduce the damage of renal tubular in early DN patients, and slow down the progression of DN.