利格列汀治疗2型糖尿病合并早期糖尿病肾病的效果观察

Clinical effect of Linagliptin on treating type 2 diabetic patients with early diabetic kidney disease

目的：观察利格列汀治疗T2DM合并早期糖尿病肾病患者的临床效果。方法入选已经确诊的T2DM合并早期糖尿病肾病患者50例，应用计算机随机分为两组，所有患者均进行糖尿病教育，严格进行饮食治疗，并进行适当的运动，利格列汀组26例，给予利格列汀5 mg口服1次／d；格列齐特组24例，给予格列齐特30 mg口服1次／d，监测血糖调整药物剂量，最大剂量为60 mg、1次／d。两组观察时间均为6个月。监测两组治疗前后HbA1c和尿Alb／Cr比值（ UACR）。结果利格列汀组HbA1c治疗后[（7．39±0．37）％]低于治疗前[（8．30±0．48）％]，差异有统计学意义（t＝14．232，P＜0．001）；格列齐特组HbA1c治疗后[（7．45±0．41）％]低于治疗前[（8．38±0．49）％]，差异有统计学意义（t＝23．146，P＜0．001）；组间HbA1c治疗后比较差异无统计学意义（ t＝－0．517，P＝0．608）。利格列汀组UACR治疗后[（83．64±37．44） mg／g]低于治疗前[（109．56±53．36） mg／g]，差异有统计学意义（t＝4．632，P＜0．001）；格列齐特组UACR治疗后[（93．58±47．17） mg／g]低于治疗前[（103．77±48．80） mg／g]，差异有统计学意义（ t＝2．909，P＝0．008）；组间UACR治疗后比较差异有统计学意义（ t＝－2．172，P＝0．035）。结论利格列汀是一种安全、有效的降糖药物，适用于T2DM合并早期糖尿病肾病患者。

Objective To assess the clinical effect of Linagliptin on treating type 2 diabetic patients with early diabetic kidney disease. Methods Fifty cases type 2 diabetes patients with early diabetic kidney dis?ease were selected and randomly divided into two groups. All patients carried out diabetes education,strict diet therapy,and proper exercise. Twenty?six cases patients were enrolled in Linagliptin group,oral Linagliptin 5 mg, 1 times/d. Twenty?four cases patients were enrolled in Gliclazide group,oral Gliclazide 30 mg,1 times/d,and monitored the blood sugar to adjust drug dosage,the maximum dose of 60 mg,1 times/d. The observation time of both groups was six months. The glycosylated hemoglobin ( HbA1c ) and urinary albumin?to?creatinine ratio ( UACR) of two groups were compared before and after treatment. Results The level of HbA1c in Linagliptin group after treatment was lower than before treatment,the difference was significant((7. 39±0. 37)% vs. (8. 30 ±0. 48)%,t=14. 232,P<0. 001). The level of HbA1c in Gliclazide group after treatment was lower than before treatment,the difference was significant((7. 45±0. 41)% vs. (8. 38±0. 49)%,t=23. 146,P<0. 001). There was no significant difference on the level of HbA1c between the two groups after treatment ( t=-0. 517, P=0. 608) . The level of UACR in Linagliptin group after treatment was lower than before treatment,the difference was significant((83. 64±37. 44) mg/g vs. (109. 56±53. 36) mg/g,t=4. 632,P<0. 001). The level of UACR in Gliclazide group after treatment was lower than before treatment,the difference was significant((93. 58±47. 17) mg/g vs. (103. 77±48. 80) mg/g,t=2. 909,P=0. 008). There was significant difference on the level of UACR between the two groups after treatment( t=-2. 172,P=0. 035) . Conclusion Linagliptin is a kind of effective and safe regent,can be used in patients with type 2 diabetes and early diabetic kidney disease.