沙格列汀治疗糖尿病肾病疗效及对肾间质纤维化和炎症因子的影响

Effect of Saxagliptin in treatment of diabetic nephropathy and influence on renal interstitial fibrosis and inflammatory factors

目的探讨沙格列汀治疗糖尿病肾病的临床疗效以及对肾间质纤维化、炎症因子的影响作用。方法选取2016年1月—2020年4月新乡市第二人民医院收治的198例糖尿病肾病患者,随机数字表法将患者分为观察组和对照组各99例。对照组患者给予常规治疗,观察组在此基础上加以沙格列汀治疗,比较两组临床疗效。结果观察组治疗后尿白蛋白(58.97±15.26)mg/L、24 h尿蛋白定量(0.52±0.15)g,低于对照组的(103.52±12.05)mg/L、(0.98±0.29)g,差异有统计学意义(P<0.05);观察组治疗后肿瘤生长因子-β(TGF-β)、Ⅳ胶原(CⅣ)、Ⅲ型前胶原(PCⅢ)、血管紧张素Ⅱ(AngⅡ)、结缔组织生长因子(CTGF)各水平分别为(3.70±1.11)ng/mL、(44.08±12.06)ng/mL、(62.37±14.54)ng/mL、(78.21±11.34)ng/L、(103.62±12.56)ng/L,低于对照组的(4.84±1.36)ng/mL、(47.51±11.47)ng/mL、(66.12±11.89)ng/mL、(110.08±14.58)ng/L、(166.37±14.49)ng/L,差异有统计学意义(P<0.05);观察组治疗后白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)各炎症因子水平分别为(16.73±5.09)、(32.25±9.67)、(23.26±6.87)pg/mL,均低于对照组的(29.85±4.33)、(60.14±10.57)、(47.39±10.10)pg/mL,差异有统计学意义(P<0.05)。结论沙格列汀治疗糖尿病肾病可明显改善患者肾功能及肾间质纤维化,控制炎症发展。

Objective To explore the clinical effect of saxagliptin in the treatment of diabetic nephropathy and the influence on renal interstitial fibrosis and inflammatory factors.Methods A total of 198 patients with diabetic nephropathy who were admitted and treated in the hospital between January 2016 and April 2020 were selected and divided into observation group and control group by random number table method, 99 cases in each group. Patients in the control group were given routine treatment, and those in the observation group were treated with saxagliptin on the basis of routine treatment. Clinical effects of the two groups were compared.Results The urinary albumin and 24 h urine protein quantitation in the observation group[(58.97±15.26) mg/L and(0.52±0.15) g]were lower than those of the control group[(103.52±12.05) mg/L and(0.98±0.29) g]after treatment(P<0.05). After treatment, levels of tumor growth factor-β(TGF-β), type Ⅳ collagen(CIV), type III procollagen(PCⅢ), angiotensin Ⅱ(AngⅡ) and connective tissue growth factor(CTGF)[(3.70±1.11) ng/mL,(44.08±12.06) ng/mL,(62.37±14.54)ng/mL,(78.21±11.34)ng/L and(103.62±12.56) ng/L]were lower than those of the control group[(4.84±1.36) ng/mL,(47.51±11.47)ng/mL,(66.12±11.89) ng/mL,(110.08±14.58) ng/L and(166.37±14.49) ng/L](P<0.05). Levels of interleukin-6(IL-6), interleukin-1β(IL-1β) and tumor necrosis factor-α(TNF-α)[(16.73±5.09) pg/mL,(32.25±9.67) pg/mL and(23.26±6.87) pg/mL]were lower than those of the control group[(29.85±4.33) pg/mL,(60.14±10.57) pg/mL and(47.39±10.10) pg/mL](P<0.05).Conclusion Saxagliptin can significantly improve renal function and renal interstitial fibrosis in patients with diabetic nephropathy, and control the development of inflammation.