西格列汀联合贝那普利治疗糖尿病肾病的临床观察

Clinical Observation of Sitagliptin Combined with Benazepril in the Treatment of Diabetic Nephropathy

目的:观察西格列汀联合贝那普利治疗糖尿病肾病(DN)的临床效果。方法:将我院2014年9月-2015年6月收治的60例DN患者按随机数字表法分为西格列汀组、贝那普利组和联合用药组,各20例。在常规治疗基础上,西格列汀组患者口服西格列汀100 mg,qd;贝那普利组患者口服贝那普利10 mg,qd;联合用药组患者口服西格列汀100 mg+贝那普利10 mg,qd。患者血压若未达标,则将用药剂量加倍;疗程均为12周。测定3组患者治疗前后的24h尿蛋白、白细胞介素6(IL-6)和血清胱抑素C(CysC)水平,观察临床疗效和不良反应发生情况。结果:联合用药组患者的总有效率(90.00%)显著高于西格列汀组(65.00%)和贝那普利组(70.00%),差异有统计学意义(P<0.05)。治疗后,3组患者的24 h尿蛋白、IL-6和CysC水平均较治疗前显著降低,且联合用药组显著低于两单独用药组,差异均有统计学意义(P<0.05)。西格列汀组和贝那普利组的上述指标比较,差异均无统计学意义(P>0.05)。3组患者在治疗期间均未见明显不良反应发生。结论:西格列汀和贝那普利均能降低DN患者的24 h尿蛋白、IL-6和CysC水平,但联合用药的效果更显著,并具有更高的临床有效率,且不影响用药安全性。

OBJECTIVE：To observe the clinical efficacy of sitagliptin combined with benazepril in the treatment of diabetic nephropathy（DN）.METHODS：Sixty DN patients admitted to our hospital during Sept.2014-Jun.2015 were divided into sitagliptin group,benazepril group,drug combination group according to random number table,with 20 cases in each group.Based on routine treatment,sitagliptin group was given sitagliptin 100 mg orally,qd;benazepril group was given Benazepril 10 mg orally,qd;drug combination group was given sitagliptin 100 mg＋benazepril 10 mg orally,qd.The drug dosage would be doubled if the blood pressure of patients in 3 groups had not yet reached the standard.Treatment course of 3 groups lasted for 12 weeks.The levels of 24 h urine protein,IL-6 and Cys-C were measured in 3 groups before and after treatment.Clinical efficacies and the occurrence of ADR were observed.RESULTS：Total response rate of drug combination group（90.00%） was significantly higher than those of sitagliptin group（65.00%） and benazepril group（70.00%）;there was statistically significance（P〈0.05）.After treatment,the levels of 24 h urine protein,IL-6 and Cys-C in 3 groups were significantly lowered,compared to before treatment;those of drug combination group was significantly lower than those of other 2 groups;there was statistically significance（P〈0.05）.There was no statistical significance in above indexes between sitagliptin group and benazepril group（P〉0.05）.No obvious ADR was found in 3 groups during treatment.CONCLUSIONS：Both sitagliptin and benazepril can decrease the levels of 24 h urine protein,IL-6 and Cys-C,while drug combination shows better effect and clinical response rate,and does not influence the safety of drug use.