磷酸西格列汀联合氯沙坦钾对糖尿病肾病患者炎症因子、纤维化指标及血管内皮因子的影响

Effects of sitagliptin phosphate combined with losartan potassium on inflammatory factors, fibrosis markers and vascular endothelial growth factor in diabetic nephropathy

摘要:

目的 研究磷酸西格列汀联合氯沙坦钾对糖尿病肾病患者炎症因子、纤维化指标及血管内皮因子的影响。方法 选取2016年3月—2017年6月东部战区总医院确诊糖尿病肾病患者80例，依据随机数字表法分为观察组和对照组，每组40例。所有患者均予氯沙坦钾与二甲双胍缓释片治疗，4周后观察组患者予磷酸西格列汀100?mg/d，1次/d。治疗12周后观察比较两组患者血糖和肾功能相关指标的变化情况；比较两组治疗前后炎症因子、纤维化相关指标及血管内皮相关因子水平变化，记录两组不良反应的发生情况。结果 治疗前两组患者血糖差异无统计学意义（P?>0.05）；治疗后两组空腹血糖（FPG）、餐后2?h血糖（2 h PG）和糖化血红蛋白（HbA1c）降低，观察组低于对照组（P?<0.05）；治疗后两组微量白蛋白尿（mAlb）、尿蛋白肌酐比值和血清胱抑素C浓度降低，观察组低于对照组（P?<0.05）；治疗后两组白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和C反应蛋白（CRP）水平降低，观察组低于对照组（P?<0.05）；治疗后两组血清基质金属蛋白酶-9（MMP-9）、层黏蛋白（LN）、透明质酸（HA）、Ⅲ型前胶原（PCⅢ）和Ⅳ型胶原（ⅣC）水平降低，对照组低于观察组（P?<0.05）；治疗后两组内皮素（ET）水平降低，观察组低于对照组（P?<0.05）；两组一氧化氮NO水平治疗后较治疗前升高，观察组高于对照组（P?<0.05）；两组不良反应发生率比较差异无统计学意义（P?>0.05）。结论 磷酸西格列汀联合氯沙坦钾治疗糖尿病肾病可抑制机体炎症状态，延缓纤维化进程，改善血管内皮舒缩功能，对肾功能起到保护作用。

Abstract:

objective To study the effects of sitagliptin phosphate combined with losartan potassium on inflammatory factors, fibrosis markers and vascular endothelial growth factor in diabetic nephropathy. Methods Totally 80 cases of diabetic nephropathy patients diagnosed in our hospital from March 2016 to June 2017 were selected and divided into observation group and control group according to the random number table method, with 40 cases in each group. All the patients were treated with losartan potassium tablets and metformin sustained release tablets, and the observation group was treated with cegretin phosphate (100 mg Qd) 4 weeks later. After 12 weeks of treatment, the changes of blood glucose and renal function in the two groups were observed and compared. The levels of inflammatory factors, fibrosis related indicators and vascular endothelial related factors were compared between the two groups, and the occurrence of adverse reactions was recorded. Results There was no statistically significant difference in blood glucose concentration between the two groups before the treatment (P?>?0.05). Fasting blood glucose (FPG), 2-hour blood glucose (2 h PG) and glycated hemoglobin (HbA1c) of the two groups decreased after the treatment, and the difference was more in the observation group than in the control group (P??0.05). Conclusion The treatment of diabetic nephropathy with sitagliptin phosphate combined with potassium losartan can inhibit the inflammatory state of the body, slow down the development of fibrosis, improve the vascular endothelial systolic function, and play a protective role in renal function.