【摘要】 目的观察口服西格列汀对2型糖尿病肾损害患者尿微量白蛋白的作用。方法血糖控制欠佳伴微量白蛋白尿的2型糖尿病患者60例随机分为两组,每组30例。在维持原生活方式及治疗方案的基础上,试验组加用西格列汀100 mg,po,qd;对照组加用格列本脲2.5 mg,po,qd,疗程均为6个月。分别于治疗前、治疗3个月及6个月末测定患者的体重指数(BMI)、尿微量白蛋白(mAIb)、糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2 h血糖(2hPBG)、血清肌酐(Scr)、尿白蛋白-肌酐比值(ACR)及血压,并观察不良反应。结果治疗6个月末,对照组FBG、2hPBG、HbA1c下降(P<0.05),BMI、Scr、血压、尿mAIb和ACR均无明显变化(P>0.05)。试验组除BMI、Scr无变化外,FBG、2hPBG、HbA1c、血压、尿mAIb和ACR均下降(P<0.05),血压、尿mAIb和ACR低于对照组,差异有显著意义(P<0.05)。对照组共出现低血糖事件10例次,试验组出现4例次,组间无显著差异(P>0.05)。结论西格列汀可降低糖尿病肾损害患者尿mAIb和ACR水平,一定程度保护患者的肾功能。更多还原

【Abstract】 AIM To observe the effects of sitagliptin on urinary microalbumin(mAIb) level in patients with type 2 diabetic renal disease.METHODS Sixty patients with type 2 diabetic renal disease whose glycosylated hemoglobin A1c(HbA1c) was higher than 7% were enrolled into this study and divided randomly into 2 groups(30 patients in each).All patients were maintained their own lifestyles and treatment.The patients in the control group were treated with glibenclamide 2.5 mg once daily while the others in the trial group with sitagliptin 100 mg once a day for at least 6 months.Body mass index(BMI),urinary microalbumin(mAIb),HbA 1c,fasting blood glucose(FBG),2 h postprandial blood glucose(2hPBG),serum creatinine(Scr),urinary albumin-to-creatinine ratio(ACR) and blood pressure(BP) were observed before and at the end of 3 and 6 months after the treatment.Adverse reactions were also recorded.RESULTS Compared with those at baseline,there were no differences in BMI,Scr,BP,urinary mAIb and ACR in the control group after 6 months treatment while FBG,2hPBG and HbA 1c had significant decrease(P < 0.05).However,the levels of FBG,2hPBG,HbA 1c,BP,urinary mAIb and ACR decreased significantly after 6 months treatment in the trial group(P < 0.05) besides BMI and Scr.The levels of BP,urinary mAIb and ACR in the trial group were lower compared with those in the control group(P < 0.05).Ten times hypoglycemic events were observed in the control group while only 4 times in the trial group,with no significant differences between two groups(P > 0.05).CONCLUSION Sitagliptin can reduce urinary mAIb and ACR levels in type 2 diabetic renal disease patients and be beneficial to kidney’s function.更多还原