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目的观察西格列汀对糖尿病合并肾损害患者肾功能及γ-谷氨酰转移酶(γ-GT)等指标的影响。方法选择早期2型糖尿病合并肾损伤且血糖控制不佳的患者67例,随机分为两组,西格列汀组32例,对照组35例。在原治疗方案的基础上,西格列汀组加用西格列汀片100 mg,每日1次;对照组可增加药物剂量或联合除二肽基肽酶4抑制剂外的降糖药物。观察时间均为12周。治疗前后检测患者空腹血糖(FPG)、糖化血红蛋白(Hb A_(1c))、β_2微球蛋白(β_2-MG)、血尿素氮(BUN)、胱抑素C(Cys C)、血肌酐(Cr)、γ-GT水平,并观察不良反应发生情况。结果治疗前两组各项指标比较差异均无显著意义(P>0.05)。治疗12周后,两组FPG和Hb A1c均下降,与治疗前比较差异显著(P<0.05),组间比较无显著差异(P>0.05)。对照组Cr、BUN、β_2-MG、Cys C、γ-GT无明显变化(P>0.05),而西格列汀组以上指标均降低(P<0.05),且低于对照组(P<0.05)。两组均无明显不良反应发生。结论西格列汀治疗糖尿病合并肾损害患者,可以降低γ-GT等指标,改善肾功能。
Objective To observe the effect of sitagliptin on renal function and γ-glutamyl transferase (γ-GT) in patients with diabetic nephropathy. Methods Sixty-seven patients with early stage type 2 diabetes mellitus with impaired renal glucose and poor glycemic control were randomly divided into two groups: 32 in sitagliptin group and 35 in control group. On the basis of the original treatment, sitagliptin group plus sitagliptin 100 mg, 1 day; control group can increase the dose of drugs or in addition to dipeptidyl peptidase 4 inhibitors other than hypoglycemic drugs. The observation time was 12 weeks. The levels of fasting blood glucose (FPG), glycosylated hemoglobin (1c), β_2-MG, BUN, Cys, Cr ), Γ-GT levels, and observe the occurrence of adverse reactions. Results There was no significant difference between the two groups before treatment (P> 0.05). After 12 weeks of treatment, FPG and Hb A1c in both groups decreased, with significant difference (P <0.05) before treatment, there was no significant difference between the two groups (P> 0.05). The levels of Cr, BUN, β_2-MG, Cys C and γ-GT in the control group were not significantly different (P> 0.05), while those in the sitagliptin group were lower than those in the control group (P <0.05) ). No significant adverse reactions occurred in both groups. Conclusion Sitagliptin treatment of diabetic patients with renal damage, can reduce γ-GT and other indicators to improve renal function.