西格列汀联合胰岛素治疗2型糖尿病合并肾病的临床效果

Clinical Effect of Sitagliptin Combined with Insulin in the Treatment of Type 2 Diabetes Mellitus Complicated with Nephropathy

目的:探讨2型糖尿病合并肾病患者采用西格列汀联合胰岛素治疗的临床效果。方法:选取2020年5月—2022年5月上海市奉贤区奉城医院收治的2型糖尿病合并肾病患者86例为观察对象,根据随机数字表法分为对照组与观察组,各43例。对照组给予瑞格列奈联合甘精胰岛素治疗,观察组给予西格列汀联合甘精胰岛素治疗。比较两组患者血糖水平、肾功能、机体炎性指标及低血糖事件发生率。结果:治疗后,两组患者空腹血糖、餐后2 h血糖、糖化血红蛋白水平均降低,观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组患者胱抑素C、β_(2)-微球蛋白、尿白蛋白排泄率水平均降低,观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组患者血清C反应蛋白、白细胞介素-6水平均降低,观察组低于对照组,差异有统计学意义(P<0.05);观察组低血糖事件发生率低于对照组,差异有统计学意义(P=0.034)。结论:西格列汀联合胰岛素能更好地调节2型糖尿病合并肾病患者的血糖水平,改善患者肾功能,减少低血糖事件发生率,降低机体炎性水平。

Objective:To investigate the clinical effect of sitagliptin combined with insulin in patients with type 2 diabetes mellitus complicated with nephropathy.Methods:From May 2020 to May 2022,eighty-six patients with type 2 diabetes mellitus and nephropathy admitted to Fengcheng Hospital in Fengxian District,Shanghai were selected as observation objects.According to the random number table method,they were divided into control group and observation group,with 43 cases in each group.The control group was treated with repaglinide combined with insulin glargine,and the observation group was treated with sitagliptin combined with insulin glargine.The blood glucose level,renal function,body inflammatory indicators and incidence of hypoglycemia events were compared between the two groups.Results:After treatment,the levels of fasting blood glucose,2-hour postprandial blood glucose and glycosylated hemoglobin in the two groups were all decreased,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).After treatment,the excretion rates of cystatin C,β_(2)-microglobulin,and urinary albumin in the two groups decreased,and the observation group was lower than the control group,with statistically significant differences(P<0.05).After treatment,the levels of serum C-reactive protein and interleukin-6 in the two groups decreased,and the observation group was lower than the control group,and the difference was statistically significant(P<0.05).The incidence of hypoglycemia events in the observation group was lower than that in the control group,and the difference was statistically significant(P=0.034).Conclusion:Sitagliptin combined with insulin can better regulate the blood glucose level in patients with type 2 diabetes mellitus complicated with nephropathy,improve the renal function of the patients,reduce the incidence of hypoglycemia events,and reduce the body's inflammatory level.