摘要
目的探讨磷酸西格列汀联合氯沙坦钾对DN患者肾功能及血清CRP、TNF-α、IL-6水平的影响。方法选取2018年1月至2019年5月绵阳市中心医院收治的92例DN患者,按照随机数字表法分为对照组和观察组,各46例。对照组患者给予氯沙坦钾治疗,观察组患者在对照组基础上加用磷酸西格列汀片,两组患者均治疗12周。观察两组患者临床疗效,比较治疗前后两组患者血糖指标、肾功能指标及炎性因子水平变化。结果治疗后观察组患者总有效率为93.48%,高于对照组的73.91%(P<0.05);与治疗前比,治疗后两组患者血清FPG、2 h PG水平及观察组患者血清HbAlc均显著降低,两组患者血清Scr、血尿酸、ACR、mAlb、24 h尿蛋白水平及观察组患者血清BUN水平均显著降低,观察组均低于对照组(P<0.05);与治疗前比,治疗后两组患者血清IL-6、TNF-α、CRP水平均显著降低,观察组低于对照组(P<0.05)。结论磷酸西格列汀联合氯沙坦钾治疗DN可有效改善患者临床症状,缓解机体炎症反应,控制血糖水平,改善肾功能。
Objective To investigate the effects of sitagliptin phosphate and losartan potassium on renal function and serum CRP,TNF-α and IL-6 levels in patients with DN.Methods From January 2018 to May 2019,92 DN patients admitted to Mianyang Central Hospital were randomly divided into the control group and the observation group,with 46 cases in each group.The control group was treated with losartan potassium,and the observation group was treated with sitagliptin phosphate tablets in addition to the control group,both groups were treated for 12 weeks.Observed the clinical effect of the two groups,and compared the changes of blood glucose indexes,renal function indexes and inflammatory factor level between the two groups before and after treatment.Results After treatment,the total effective rate in the observation group was 93.48%,which was higher than the control group 73.91%(P<0.05).Compared with the pre-treatment,the levels of FPG,2 hPG in the two groups and the HbAlc in the observation group decreased significantly after treatment,the serum Scr,blood uric acid,ACR,mAlb,24 h urine protein levels in the two groups and the serum BUN level in the observation group reduced significantly;the observation group was all lower than the control group(P<0.05);Compared with the pre-treatment,the levels of serum IL-6 and TNF-α in the two group decreased significantly,the observation group was lower than the control group(P<0.05).Conclusion Sitagliptin phosphate combined with losartan potassium in the treatment of DN can effectively improve the clinical symptoms of patients,relieve the body's inflammatory response,adjust the blood glucose levels,and improve ranal function.
作者
刘小英
方向明
叶文春
谯艳
漆晓玲
刘红梅
LIU Xiao-ying;FANG Xiang-ming;YE Wen-chun;QIAO Yan;QI Xiao-ling;LIU Hong-mei(Department of Endocrinology,Mianyang Central Hospital,Mianyang 621099,Sichuan,China)