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目的:观察西格列汀联合厄贝沙坦治疗早期糖尿病肾病的疗效及安全性。方法:初次诊断为糖尿病肾病的患者49例随机分为观察组25例和对照组24例。在糖尿病饮食、健康教育及规范降糖药物治疗基础上,对照组给予厄贝沙坦片150 mg,po,qd;观察组在对照组基础上再加用西格列汀片100 mg,po,qd。均维持治疗3个月。比较两组患者治疗前后空腹血糖(FBG)、餐后血糖(PBG)、糖化血红蛋白(Hb A1c),收缩压(SBP)、舒张压(DBP),尿微量白蛋白(m Alb)、体质指数(BMI)等指标变化,以及低血糖发生情况。结果:观察组患者治疗后FBG、PBG、Hb A1c、SBP、DBP、m Alb均较治疗前显著降低(P<0.05)。对照组治疗后FBG、PBG、Hb A1c无明显变化(P>0.05),SBP、DBP、m Alb有明显下降(P<0.05)。治疗后观察组FBG、PBG、Hb A1c、m Alb均显著低于对照组患者(P<0.05),两组间SBP、DBP比较差异无统计学意义(P>0.05)。治疗前后两组患者BMI无明显变化(P>0.05)。观察组发生低血糖1例,与对照组发生率比较,差异无统计学意义(P>0.05)。结论:西格列汀联合厄贝沙坦治疗早期糖尿病肾病,能有效降低患者血糖,减少m Alb排泄,延缓肾病进展。
Objective: To observe the efficacy and safety of sitagliptin and irbesartan in the treatment of early diabetic nephropathy. Methods: 49 patients with primary diabetic nephropathy were randomly divided into observation group (n = 25) and control group (n = 24). On the basis of diabetic diet, health education and normative hypoglycemic drug treatment, the control group was given irbesartan 150 mg, po, qd; the observation group was treated with sitagliptin 100 mg, po, qd. All patients were treated for 3 months. FBG, PBG, Hb A1c, SBP, DBP, m Alb, BMI) and other indicators, and hypoglycemia. Results: The FBG, PBG, Hb A1c, SBP, DBP and m Alb in observation group were significantly lower than those before treatment (P <0.05). The levels of FBG, PBG and Hb A1c in the control group were not significantly changed (P> 0.05), SBP, DBP and m Alb were significantly decreased (P <0.05). After treatment, FBG, PBG, Hb A1c and m Alb in the observation group were significantly lower than those in the control group (P <0.05). There was no significant difference in SBP and DBP between the two groups (P> 0.05). There was no significant difference in BMI between the two groups before and after treatment (P> 0.05). One case of hypoglycemia occurred in the observation group, with no significant difference compared with the control group (P> 0.05). Conclusion: The combination of sitagliptin and irbesartan in the treatment of early diabetic nephropathy can effectively reduce the blood glucose, reduce the excretion of m Alb and delay the progression of nephropathy.