Sitagliptin For Type 2 Diabetes Early Kidney Disease Curative Effect Observation

Objective:Diabetic nephropathy(diabetic nephropathy, DN) is one of the main comp lications of diabetes, is leading to end-stage renal disease(end- stage takes di seases, ESRD, the main reason.China now has 92 million people with diabetes,with the increase of diabetes patients, the prevalence of DN also gradually in creased, the DN in type 1 diabetes prevalence of about 33%- 33%, prevalenc e of type 2 diabetes is about 20%- 20% [1].In sugar metabolism, growth facto rs and hemodynamic changes under the interaction of many factors such as the rate of glomerular filtration, blood flow and pressure change, renal tissue isch emia and hypoxia, protein non enzymatic glycosylation, polyol pathway activati on and oxidative stress.These anomalies of long-standing has led to an increase d glomerular mesangial matrix and basement membrane synthesis and the mech anism of glomerular mesangial and basement membrane degradation, eventually lead to glomerular sclerosis.Because the disease accompanied by sugar metabo lic disorder and often merge more severe cardiovascular complications, such as general kidney disease is complex, so its treatment is poor prognosis.Dipeptide base peptidase IV(DPP- 4) inhibitors sig, column the hypoglycemic effect of statins have been clinically to confirm, it can not only control blood sugar, also can reduce weight, reduce the risk of hypoglycemia event occurs.New research suggests that im promoting insulin analogue protection effect on diabetic nephropathy [3], this for the treatment of patients with diabetic nephrop athy, provides a new treatment idea.1.To investigate the effect of Sitagliptin in the treatment of diabetic nephr opathy.2. To investigate the Sitagliptin effects on plasma BNP, Hcy.Methods:Study selection in May 2014 to January 2015 in Shanxi Province people’s hospital endocrinology outpatient and hospitalization of 33 patients with early nephropathy in type 2 diabetes, aged 40 to 75 years old, and the urine trace albumin excretion of 20-200 ug/min or 30 to 300 mg / 24 h.Randomized, control group 16 cases, according to the original treatment can increase the drug doses or joint hypoglycemic drugs other than the DPP 4 inhibitors.Observation group of 17 cases,given Sitagliptin hypoglycemic therapy.Two groups of control objectives are Hb A1c< 7%.By observing the two groups before and after treatment in patients with Hb A1 c,urine trace albumin, BNP, the change of HCY levels, analysis the west Glenn dean effect on the treatment of patients with early nephropathy in type 2 diabetes.Results:obvious Curative effect comparison:1.The blood sugar,blood lipids:between groups of FPG,2 h PG, Hb A1 c,TC,TG,compared with paired t test between grou ps,statistically significant difference(t=2.366,2.048,2.195,2.446,2.195, p<0.05).2.P earson correlation analysis showed that urinary inhibition and urinary albumin excretion rate, Cys C and BNP, BNP and a positivecorrelation between urinary albumin excretion rate,(r=0.644,0.683),(r=0.387,0.526),(r=0.675,0.697).3 The tre atment group before and after treatment Cys C,BNP,urinary albumin excretion rate,P<0.05.the difference is statistically significant Paired t test between froup s,P<0.05,the difference is statistically significant.Paired t test between groups,P<0.05,the difference is statistically significant Prompt Sitagliptin for the above i ndicators have improved effect.Conclusions:1,type 2 diabetes mellitus patients with early nephropathy sitagliptin therapy to control blood sugar,reduce the nuune trace albumin excretion rate,with kidney protection.2,Cys C,BNP levels increased with the increase of UAER,Cys C,BNP was positively correlated with UAER.3, Sitagliptin can reduce plasma BNP, Cys C,HCY levels, a kidney protection.