沙格列汀对2型糖尿病慢性肾脏疾病患者同型半胱氨酸、高敏C反应蛋白及尿白蛋白肌酐比值水平影响的研究

Clinical study on the effect of saxagliptin on homocysteiune,hsC-RP and urinary albumin/creatine ratio in patients with chronic kidney disease

目的探讨沙格列汀对糖尿病慢性肾脏疾病(CKD)患者血清同型半胱氨酸(Hcy)、高敏C反应蛋白(hsC-RP)及UAlb/Cr水平的影响。方法将82例CKD患者分为两组,治疗组在原治疗基础上予沙格列汀5mg,1次/d,对照组原治疗不变,比较两组治疗前后指标变化。结果治疗前两组间各指标比较差异均无统计学意义。治疗组治疗前后各指标比较差异均有统计学意义(P<0.01),对照组Hcy、hsC-RP和UAlb/Cr治疗后较治疗前升高(P<0.01)。两组治疗前后SBP、平均动脉压、HDL-C、LDL-C、Hcy、hsC-RP和UAlb/Cr变化值比较差异有统计学意义(P<0.01)。相关性分析显示,两组治疗前后UAlb/Cr与Hcy、hsC-RP均呈正相关。结论血清Hcy、hsC-RP与CKD存在相关性,沙格列汀可有效降低Hcy、hsC-RP和UAlb/Cr水平,下调BP、体重,调节HDL-C、LDL-C代谢,对糖尿病肾脏有保护作用。

Objective To investigate the effect of saxagliptin on the serum levels of homocysteiune （Hcy）,high sensitivity C-reactive protein （hsC-RP） and UAlb/Cr in patients with chronic kidney disease （CKD） in diabetes. Methods 82 cases of CKD were divided into two groups, 57 patients with CKD were treated with 5 mg saxagliptin once daily besides privious regimes, and the other 25 patients with CKD were treated with only previcious regimens. The levels of general data and biochemical characteristics were detected before and after treatment. Results The differences in all indices between two groups before treatment were not significant respectively. The differences in all indices after treatment were significant respectively in treatment group （P〈0.01）,the differences of Hcy, hsC-RP and UAlb/Cr after treatment were significant respectively in control group （P〈0.01）. There were significant differences of SBP,mean blood pressure, HDL-C,LDL-C, Hcy, hsC-RP and UAlb/Cr of two groups. The correlations of UAlb/Cr with Hcy,and hsC-RP in two groups were positively significant respectively. Conclusion Serum Hcy and hsC-RP are high-positively correlated with CKD. Administrating of saxagliptin in CKD is effective in improving UAlb/Cr by downregulating Hcy and hsC-RP, and lowing blood pressure, BMI and LDL-C.