[关键词]
[摘要]
目的 系统评价二肽基肽酶-4(DPP-4)抑制剂西格列汀对中国2型糖尿病肾病患者的保护作用。方法 计算机检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普数据库(VIP)、万方数据库等数据库,并追溯纳入文献的参考文献,时限为建库至2017年3月。获取西格列汀对中国2型糖尿病肾病的保护作用的随机对照试验(RCTs),采用RevMan 5.0软件对各项指标进行Meta-分析。结果 共纳入12篇RCT,包括糖尿病肾病患者788例。Meta-分析结果显示:西格列汀组在降低血糖指标空腹血糖、糖化血红蛋白、餐后2 h血糖及体质量指数,和肾脏功能指标尿白蛋白肌酐比值、尿微量白蛋白、高敏C反应蛋白、胱抑素等方面均优于常规治疗对照组,差异有统计学意义(MD<0,P<0.05);在降低肌酐、尿白蛋白排泄率、β2-微球蛋白方面,两组差异无统计学意义。结论 新型降血糖药物DPP-4抑制剂西格列汀不仅可以降低血糖,还可以对糖尿病肾病患者肾脏起保护作用。
[Key word]
[Abstract]
Objective To investigate the protective effects of sitagliptin as dipeptidyl peptidase-4 (DPP-4) inhibitor on kidney in patients with type 2 diabetes mellitus. Methods The related literatures in databases were searched including CNKI, WanFang, VIP, CBM and so on. Randomized controlled trials (RCTs) of sitagliptin for the treatment of type 2 diabetic nephropathy were included, data were collected with time limit from establishment to March, 2017 and also retrieved manually, Meta-analysis of the data was performed by using RveMan 5.0. Results Twelve RCTs were collected, including 788 diabetic nephropathy patients. The results of Meta-analysis showed that sitagliptin group can effectively reduce the FBG, HbA1c, 2 hPBG, BMI, ACR, mALB, hs-CRP, and Cys C (MD < 0, P<0.05) compared with the routine therapy group. There was no significant difference in index of β2-MG, Scr, and UAER between two groups. Conclusion As the new kind of hypolycemic agent, DPP-4 inhibitor sitagliptin can not only reduce the blood glucose but also protect the renal function of type 2 diabetic nephropathy patients.
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[基金项目]
重庆市社会事业与民生保障科技创新专项(cstc2015shmszx120073,cstc2017shmsA130105);重庆市万州科技计划基金(201403055)