西格列汀联合阿托伐他汀对早期2型糖尿病肾病患者尿微量白蛋白与肌酐比值的影响

Effects of sitagliptin in combination with atorvastatin on urinary albumin-to-creatinine ratio in type 2 diabetic patients with early nephropathy

目的:观察西格列汀联合阿托伐他汀对早期2型糖尿病肾病患者尿微量白蛋白与肌酐比值(ACR)的影响。方法:选择2013年1月至2015年6月揭阳市人民医院收治的60例早期2型糖尿病肾病患者作为研究对象,根据入院顺序随机分为治疗组和对照组,每组各30例,两组患者均予以格列齐特30 mg(每天1次)起始降糖治疗,治疗组在此基础上加用西格列汀100 mg(每天1次)和阿托伐他汀20 mg(每天1次),疗程12周,观察治疗后两组患者空腹血糖(FPG)、早餐后2 h血糖(PPG)、糖化血红蛋白(HbA1c)、C反应蛋白(CRP)、尿微量白蛋白排泄率(UAER)和尿微量白蛋白/尿肌酐(ACR)变化。结果:治疗后两组FPG、PPG、HbA1c及ACR均明显下降(P<0.05),治疗组ACR下降较对照组更显著(P<0.05);治疗后治疗组CRP明显下降(P<0.05),对照组下降不明显(P>0.05)。结论:西格列汀联合阿托伐他汀可显著降低2型糖尿病肾病患者ACR,有效起到肾功能保护作用。

Objective：To investigate the effects of sitagliptin combined with atorvastatin on urinary albumin-to-creatinine ratio （ ACR） in type 2 diabetic patients with early nephropathy. Methods：Included in this study were 60 type 2 diabetic patients with early nephropathy treated at Jieyang Municipal People′s Hospital between January 2013 and June 2015. According to the time of admission, the subjects were randomly divided into treatment group and control group （ n= 30 each ） . The two groups received gliclazide 30 mg qd for initial hypoglycemic therapy. The treatment group was additionally given sitagliptin 100 mg qd and atorvastatin 20 mg qd,for 12 weeks. After treatment,the changes in fasting plasma glucose （FPG）,2 h glucose （PPG） after breakfast,glycated hemoglobin （HbA1c）,C-reactive protein （CRP）,urinary albumin excretion rate （UAER） and urinary ACR were determined of the two groups（P〈0.05）. Results：After treatment,there was remarkable reduction in FPG,PPG,HbA1c and ACR from baseline in the two groups. The reduction in ACR post-treatment was more significant in the study group than in the control group （P〈0.05）; After treatment,CRP decreased significantly from baseline in the study group （ P〈0.05） ,but no significant decline was noted in the control group （ P〉0.05） . Conclusion：Sitagliptin combined with atorvastatin may significantly reduce ACR in type 2 diabetic patients with nephropathy,and may effectively play a reno-protective role in these patients.