目的 探討西格列汀聯(lián)合坎地沙坦治療糖尿病腎病的臨床療效。方法 選取2016年3月-2017年3月在西安市第九醫(yī)院治療的糖尿病腎病患者130例，隨機(jī)分為對(duì)照組（65例）和治療組（65例）。對(duì)照組口服坎地沙坦酯片，8 mg/次，1次/d；治療組在對(duì)照組的基礎(chǔ)上口服磷酸西格列汀片，100 mg/次，1次/d。兩組患者均治療4周。評(píng)價(jià)兩組患者臨床療效，同時(shí)比較治療前后兩組患者血糖指標(biāo)、腎功能指標(biāo)、胱抑素C和同型半胱氨酸水平以及血清學(xué)指標(biāo)。結(jié)果 對(duì)照組和治療組的總有效率分別為81.54%、93.85%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血紅蛋白（HbAlc）、血肌酐（Scr）、血尿素氮（BUN）、尿白蛋白肌酐比值（ACR）水平均顯著降低（P<0.05）；且治療組血糖和腎功能指標(biāo)低于對(duì)照組（P<0.05）。治療后，兩組患者胱抑素C、同型半胱氨酸水平均明顯降低（P<0.05）；且治療組患者比對(duì)照組降低更明顯（P<0.05）。治療后，兩組患者血清β₂-MG和γ-GT水平均顯著降低（P<0.05）；且治療組患者上述指標(biāo)低于對(duì)照組（P<0.05）。結(jié)論 西格列汀聯(lián)合坎地沙坦治療糖尿病腎病可有效控制血糖，顯著改善腎功能及氧化應(yīng)激狀態(tài)。

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.