西格列汀联合螺内酯对糖尿病肾病患者肾功能和血脂水平的影响

目的 研究西格列汀联合螺内酯对糖尿病肾病患者肾功能和血脂水平的影响。方法 选择2015年1月-2017年12月宿州市立医院收治的60例糖尿病肾病患者，随机分为两组。对照组口服螺内酯，每次20 mg，每天1次；观察组联合口服西格列汀，每次100 mg，每天1次。两组均治疗6个月。比较两组治疗前后的肾功能和血脂水平。结果 观察组的有效率（80.00%）明显高于对照组（56.67%），差异有统计学意义（P<0.05）。治疗后，两组24 h尿蛋白定量和尿白蛋白排泄率均较治疗前显著减少，同组治疗前后比较差异有统计学意义（P<0.05）；且观察组减少更为明显，组间差异有统计学意义（P<0.05）；但两组血肌酐和血尿素氮比较，差异无统计学意义。治疗后，两组的三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）和总胆固醇（TC）水平均明显降低，高密度脂蛋白胆固醇（HDL-C）水平明显升高，同组治疗前后比较差异有统计学意义（P<0.05）；且观察组的改善幅度更为明显，组间差异有统计学意义（P<0.05）。结论 螺内酯以及西格列汀联合使用有助于提高糖尿病肾病患者的治疗效果，有效改善肾功能和控制血脂水平，值得应用推广。

Effects of spironolactone combined with sitagliptin on renal function and blood lipid in patients with diabetic nephropathy

Objective To investigate the effect of spironolactone combined with sitagliptin on renal function and blood lipid in patients with diabetic nephropathy.Methods Selected 60 cases of patients with diabetic nephropathy who were treated in our hospital from January 2015 to December 2017, divided into two groups randomly. The control group was treated with spironolactone, and the observation group was given oral administration of sitagliptin.Results After treatment, the effective rate of the observation group was significantly higher than control group (P<0.05). After treatment, the two groups of 24h urine protein quantitative and urinary albumin excretion rate were significantly less than before treatment, and the observation decreased more significantly (P<0.05). However, there was no significant difference in serum creatinine and blood urea nitrogen between the two groups. The levels of TG, LDL-C and TC in the two groups were significantly decreased (P<0.05), and the HDL-C level increased significantly (P<0.05), and the improvement in the observation group was more significant (P<0.05).Conclusion The combination of spironolactone and sitagliptin can help to improve the therapeutic effect of diabetic nephropathy, improve renal function and control the level of blood lipid, which is worthy of application.