目的 探讨西格列汀联合坎地沙坦治疗糖尿病肾病的临床疗效。方法 选取2016年3月-2017年3月在西安市第九医院治疗的糖尿病肾病患者130例，随机分为对照组（65例）和治疗组（65例）。对照组口服坎地沙坦酯片，8 mg/次，1次/d；治疗组在对照组的基础上口服磷酸西格列汀片，100 mg/次，1次/d。两组患者均治疗4周。评价两组患者临床疗效，同时比较治疗前后两组患者血糖指标、肾功能指标、胱抑素C和同型半胱氨酸水平以及血清学指标。结果 对照组和治疗组的总有效率分别为81.54%、93.85%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbAlc）、血肌酐（Scr）、血尿素氮（BUN）、尿白蛋白肌酐比值（ACR）水平均显著降低（P<0.05）；且治疗组血糖和肾功能指标低于对照组（P<0.05）。治疗后，两组患者胱抑素C、同型半胱氨酸水平均明显降低（P<0.05）；且治疗组患者比对照组降低更明显（P<0.05）。治疗后，两组患者血清β₂-MG和γ-GT水平均显著降低（P<0.05）；且治疗组患者上述指标低于对照组（P<0.05）。结论 西格列汀联合坎地沙坦治疗糖尿病肾病可有效控制血糖，显著改善肾功能及氧化应激状态。

Objective To investigate the clinical efficacy of sitagliptin combined with candesartan in treatment of diabetic nephropathy. Methods Patients (130 cases) with diabetic nephropathy in Ninth Hospital of Xi'an from March 2016 to March 2017 were randomly divided into control (65 cases) and treatment (65 cases) groups. Patients in the control group were po administered with Candesartan Cilexetil Tablets, 8 mg/time, once daily. Patients in the treatment group were po administered with Sitagliptin Phosphate Tablets on the basis of the control group, 100 mg/time, once daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the blood glucose and renal function indexes, cystatin C and homocysteine levels, serological indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 81.54% and 93.85%, respectively, and there were differences between two groups (P<0.05). After treatment, the FPG, 2 h PG, HbAlc, Scr, BUN, and ACR in two groups were significantly decreased (P<0.05). And blood glucose and renal function indexes in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the cystatin C and homocysteine levels in two groups were significantly decreased (P<0.05). And these indexes in the treatment group decreased more significantly than those in the control group (P<0.05). After treatment, the β₂-MG and γ-GT levels in two groups were significantly decreased (P<0.05). And these indexes in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Sitagliptin combined with candesartan can effectively control blood glucose in treatment of diabetic nephropathy, and can significantly improve renal function and oxidative stress state.