[關(guān)鍵詞]
[摘要]
目的 系統(tǒng)評價二肽基肽酶-4(DPP-4)抑制劑西格列汀對中國2型糖尿病腎病患者的保護作用。方法 計算機檢索中國知網(wǎng)(CNKI)、中國生物醫(yī)學文獻數(shù)據(jù)庫(CBM)、維普數(shù)據(jù)庫(VIP)、萬方數(shù)據(jù)庫等數(shù)據(jù)庫,并追溯納入文獻的參考文獻,時限為建庫至2017年3月。獲取西格列汀對中國2型糖尿病腎病的保護作用的隨機對照試驗(RCTs),采用RevMan 5.0軟件對各項指標進行Meta-分析。結(jié)果 共納入12篇RCT,包括糖尿病腎病患者788例。Meta-分析結(jié)果顯示:西格列汀組在降低血糖指標空腹血糖、糖化血紅蛋白、餐后2 h血糖及體質(zhì)量指數(shù),和腎臟功能指標尿白蛋白肌酐比值、尿微量白蛋白、高敏C反應(yīng)蛋白、胱抑素等方面均優(yōu)于常規(guī)治療對照組,差異有統(tǒng)計學意義(MD<0,P<0.05);在降低肌酐、尿白蛋白排泄率、β2-微球蛋白方面,兩組差異無統(tǒng)計學意義。結(jié)論 新型降血糖藥物DPP-4抑制劑西格列汀不僅可以降低血糖,還可以對糖尿病腎病患者腎臟起保護作用。
[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.
[中圖分類號]
[基金項目]
重慶市社會事業(yè)與民生保障科技創(chuàng)新專項(cstc2015shmszx120073,cstc2017shmsA130105);重慶市萬州科技計劃基金(201403055)