西格列汀联合贝那普利治疗糖尿病肾病的临床观察

摘要

目的：观察西格列汀联合贝那普利治疗糖尿病肾病（DN）的临床效果。方法：将我院2014年9月－2015年6月收治的60例DN患者按随机数字表法分为西格列汀组、贝那普利组和联合用药组，各20例。在常规治疗基础上，西格列汀组患者口服西格列汀100 mg，qd；贝那普利组患者口服贝那普利10 mg，qd；联合用药组患者口服西格列汀100 mg+贝那普利10 mg，qd。患者血压若未达标，则将用药剂量加倍；疗程均为12周。测定3组患者治疗前后的24 h尿蛋白、白细胞介素6（IL-6）和血清胱抑素C（CysC）水平，观察临床疗效和不良反应发生情况。结果：联合用药组患者的总有效率（90.00％）显著高于西格列汀组（65.00％）和贝那普利组（70.00％），差异有统计学意义（P＜0.05）。治疗后，3组患者的24 h尿蛋白、IL-6和CysC水平均较治疗前显著降低，且联合用药组显著低于两单独用药组，差异均有统计学意义（P＜0.05）。西格列汀组和贝那普利组的上述指标比较，差异均无统计学意义（P＞0.05）。3组患者在治疗期间均未见明显不良反应发生。结论：西格列汀和贝那普利均能降低DN患者的24 h尿蛋白、IL-6和CysC水平，但联合用药的效果更显著，并具有更高的临床有效率，且不影响用药安全性。%OBJECTIVE:To observe the clinical efficacy of sitagliptin combined with benazepril in the treatment of diabetic nephropathy(DN). METHODS:Sixty DN patients admitted to our hospital during Sept. 2014-Jun. 2015 were divided into sitagliptin group,benazepril group,drug combination group according to random number table,with 20 cases in each group. Based on routine treatment,sitagliptin group was given sitagliptin 100 mg orally,qd;benazepril group was given Benazepril 10 mg orally,qd;drug combination group was given sitagliptin 100 mg+benazepril 10 mg orally,qd. The drug dosage would be doubled if the blood pressure of patients in 3 groups had not yet reached the standard. Treatment course of 3 groups lasted for 12 weeks. The levels of 24 h urine protein,IL-6 and Cys-C were measured in 3 groups before and after treatment. Clinical efficacies and the occurrence of ADR were observed. RESULTS:Total response rate of drug combination group(90.00%)was significantly higher than those of sitagliptin group (65.00%)and benazepril group(70.00%);there was statistically significance(P0.05). No obvious ADR was found in 3 groups during treatment. CONCLUSIONS:Both sitagliptin and benazepril can decrease the levels of 24 h urine protein,IL-6 and Cys-C,while drug combination shows better effect and clinical response rate,and does not influence the safety of drug use.