西格列汀联合厄贝沙坦治疗早期糖尿病肾病的临床效果研究

目的 研究厄贝沙坦联合西格列汀治疗早期糖尿病肾病的临床效果.方法 选择2015年11月至2016年11月接受治疗的早期糖尿病肾病患者90例,患者按照随机数字表达法分为对照组和观察组,每组45例.对照组予以单一的西格列汀治疗,观察组在对照组的治疗基础上增加厄贝沙坦治疗,比较2组患者临床效果[治疗前后血清抑制素C(CysC)、糖化血红蛋白(HbA1c)、尿微量白蛋白(U-mAlb)及24 h尿白蛋白排泄率(UAER)的变化情况]及不良反应的发生情况.结果 2组患者治疗前CysC、HbA1c、U-mAlb、UAER指标差异无统计学意义(P>0.05);治疗后1个月,观察组CysC、HbA1c、U-mAlb、UAER指标下降幅度均高于对照组,差异有统计学意义(P<0.05);治疗后3个月,观察组CysC、HbA1c、U-mAlb、UAER指标的下降幅度均明显高于对照组,差异有统计学意义(P<0.01).2组患者不良反应发生率差异无统计学意义(P>0.05).结论 厄贝沙坦联合西格列汀的治疗方法不仅可以有效改善早期糖尿病肾病患者的肾功能,而且还可对患者的肾脏起到良好的保护作用,值得推广.

Therapeutic effects of sitagliptin combined with irbesartan on early diabetic nephropathy

Objective To observe the therapeutic effects of sitagliptin combined with irbesartan on early diabetic nephropathy.Methods Ninety patients with early diabetic nephropathy who were treated in our hospital from November 2015 to November 2016 were divided into control group and observation group according to random number table.The patients in control group were treated by sitagliptin only,however,the patients in observation group were treated by sitagliptin combined with irbesartan,then the therapeutic effects,the changes of serum inhibin C (CysC),HbA1c, microalbuminuria (24h) and UAER urinary albumin excretion rate (U-mAlb) before and after treatment and adverse effects were observed and compared between two groups.Results Before treatment there were no significant differences in the levels of CysC,HbA1c,U-mAlb, UAER between two groups (P >0.05),however after 1-month treatment,the decrease degree of CysC,HbA1c,U-mAlb, UAER in observation group was significantly higher than that in control group (P <0.05), after 3-month treatment,the decrease degree of CysC,HbA1c,U-mAlb,UAER was significantly higher than that in control group (P <0.01).However there were no significant differences in the incidence rates of adverse reactions between two groups(P>0.05).Conclusion The irbesartan combined with sitagliptin can not only effectively improve renal function of patients with early diabetic nephropathy,but also can effective protect kidney of patients,thus,which is worth using widely in clinical practice.