西格列汀联合贝那普利治疗早期糖尿病肾病的效果及对血清IL-6、IL-18、TGF-β1的影响

Therapeutic Effect of Sitagliptin Combined with Benazepril on Early Diabetic Nephropathy and Its Effect on Serum IL-6,IL-18 and TGF-β1

目的观察西格列汀联合贝那普利治疗早期糖尿病肾病(diabetic nephropathy,DN)的效果。方法选取2018年7月—2019年10月在我院就诊的92例早期DN患者,根据治疗方法不同分为观察组和对照组各46例,对照组采用非二肽基肽酶-4抑制剂类降糖药物联合贝那普利治疗,观察组在对照组基础上加用西格列汀治疗,疗程为12周。观察比较两组血糖相关指标、肾功能指标、炎性指标差异以及治疗期间不良反应发生情况。结果治疗后两组空腹血糖(FPG)、餐后2 h血糖(2 h PBG)、空腹胰岛素及糖化血红蛋白(HbA1c)均较治疗前降低(P<0.05或P<0.01),且观察组FPG、2 h PBG及HbA1c较对照组降低幅度更大(P<0.01)。两组治疗后胱抑素C、β2微球蛋白及尿白蛋白排泄率均低于治疗前,且观察组较对照组降低幅度更大,差异有统计学意义(P<0.05或P<0.01)。两组治疗后白细胞介素-6、白细胞介素-18及转化生长因子-β1均低于治疗前,且观察组较对照组降低幅度更大,差异有统计学意义(P<0.01)。两组治疗期间均未发生明显不良反应。结论西格列汀联合贝那普利可有效控制早期DN患者血糖,改善肾功能,同时调节血清炎性因子水平。

Objective To observe the therapeutic effect of sitagliptin combined with benazepril in early diabetic nephropathy(DN).Methods A total of 92 patients with early DN who were treated in our hospital from July 2018 to October 2019 were entered into this study.They were randomly divided into the observation group(n=46)and the control group(n=46)according to different treatment methods.The control group was treated with non-dipeptidyl peptidase-4 inhibitor hypoglycemic drugs combined with benazepril,the observation group was treated with sitagliptin on the basis of the control group,and the treatment course was 12 weeks.The differences of blood glucose related indicators,renal function indexes and immune inflammation indexes between the two groups were observed and compared.Results After treatment,fasting blood glucose(FPG),2h postprandial blood glucose(2 h PBG),fasting insulin and glycosylated hemoglobin(HbA1c)were lower than those before treatment(P<0.05 or P<0.01),and FPG,2 h PBG and HbA1c of the observation group were decreased more than those in the control group(P<0.01).After treatment,Cystatin C,β2 microglobulin and urinary albumin excretion rate of both groups were lower than those before treatment,and the indicators were decreased more in the observation group than in the control group(P<0.05 or P<0.01).After treatment,interleukin-6,interleukin-18 and transforming growth factor-β1 in both groups were lower than those before treatment,and the observation group decreased more than the control group(P<0.01).No obvious adverse reactions occurred in the two groups during treatment.Conclusion Sitagliptin combined with benazepril can control the blood sugar of early DN patients,improve renal function,and regulate the levels of immune inflammatory factors.