作　　者： (张滨）; (连续）; (郑淑红）; (赵欣）; (孙小力）; (张珍）;

机构地区： 牡丹江医学院,黑龙江牡丹江157001

出　　处： 《中国现代医生》 2017年第22期43-45,52,共4页

摘　　要： 目的 研究西格列汀对早期2型糖尿病肾病(diabetic kidney disease,DKD)的影响。方法选取2型糖尿病并发早期糖尿病肾病的患者60例,随机分为实验组30例和对照组30例。两组均采用糖尿病饮食管理和运动治疗。对照组给予二甲双胍治疗,实验组给予西格列汀治疗,持续服药12周。观察治疗前后空腹血糖(FBG)、餐后2 h血糖(2h PFG)、糖化血红蛋白(Hb A1c)、血脂、尿酸(UA)、肾损伤因子-1(KIM-1)、尿N-乙酰-β-氨基葡萄糖苷酶(NAG)、中性粒细胞与淋巴细胞比值(NLR)、尿白蛋白与肌酐比值(ACR)等的水平变化。结果实验组治疗后FBG、2h PFG、Hb A1c、血脂、UA、Hs-CRP、KIM-1、NAG、NLR、ACR较治疗前明显下降,差异有统计学意义(P<0.05);对照组治疗后FBG、2h PFG、Hb A1c、TG、TC、ACR较治疗前下降(P<0.05);两组治疗后FBG、2h PFG、Hb A1c、TC、UA、KIM-1、NAG、NLR、ACR比较,差异有统计学意义(P<0.05)。结论西格列汀可以有效控制早期DKD患者的血糖水平,减少UA、KIM-1、NAG、NLR、ACR的水平,可减轻肾小管的损伤,有利于延缓DKD的病程进展。 Objective To study the effect of sitagliptin on early type 2 diabetic kidney disease （DKD）. Methods A total of 60 patients with type 2 diabetes mellitus complicated with early diabetic kidney disease were selected and randomly divided into experimental group （n=30） and control group （n=30）. Both groups were given diabetic diet management and exercise therapy. The control group was given metformin, and the experimental group was given sitagliptin. The medica- tion lasted for 12 weeks. Changes of fasting blood glucose （FBG）, 2-hour postprandial blood glucose （2hPFG）, glycosy- lated hemoglobin （HbAlc）, blood lipids, uric acid （UA）, kidney injury factor-1 （KIM-1）, urinary N-acetyl-[^-aminoglu- cosidase（NAG）, neutrophils and lymphocyte ratio （NLR）, urinary albumin and creatinine ratio（ACR） before and after the treatment were observed. Results After the treatment, FBG, 2hPFG, HbAlc, blood lipid, UA, hs-CRP, KIM-1, NAG, NLR, ACR were significantly decreased compared with those before treatment in the experimental group（P〈0.05）. The levels of FBG, 2hPFG, HbAlc, TG, TC and ACR in the control group after the treatment were lower than those before treat- ment（P〈O.05）. There were significant differences in FBG, 2hPFG, HbAlc, TC, UA, KIM-1, NAG, NLR and ACR be tween the two groups after treatment（P〈0.05）. Conclusion Sitagliptin can effectively control the blood glucose level of early DKD patients, reduce the levels of UA, KIM-1, NAG, NLR and ACR, and can reduce the damage of renal tubules, which is helpful to delay the progression of DKD.

关 键 词： 糖尿病肾病 西格列汀 肾损伤因子 尿 乙酰 氨基葡萄糖苷酶