目的 研究西格列汀聯(lián)合螺內(nèi)酯對(duì)糖尿病腎病患者腎功能和血脂水平的影響。方法 選擇2015年1月-2017年12月宿州市立醫(yī)院收治的60例糖尿病腎病患者，隨機(jī)分為兩組。對(duì)照組口服螺內(nèi)酯，每次20 mg，每天1次；觀察組聯(lián)合口服西格列汀，每次100 mg，每天1次。兩組均治療6個(gè)月。比較兩組治療前后的腎功能和血脂水平。結(jié)果 觀察組的有效率（80.00%）明顯高于對(duì)照組（56.67%），差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組24 h尿蛋白定量和尿白蛋白排泄率均較治療前顯著減少，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組減少更為明顯，組間差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；但兩組血肌酐和血尿素氮比較，差異無(wú)統(tǒng)計(jì)學(xué)意義。治療后，兩組的三酰甘油（TG）、低密度脂蛋白膽固醇（LDL-C）和總膽固醇（TC）水平均明顯降低，高密度脂蛋白膽固醇（HDL-C）水平明顯升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組的改善幅度更為明顯，組間差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 螺內(nèi)酯以及西格列汀聯(lián)合使用有助于提高糖尿病腎病患者的治療效果，有效改善腎功能和控制血脂水平，值得應(yīng)用推廣。

Objective To investigate the effect of spironolactone combined with sitagliptin on renal function and blood lipid in patients with diabetic nephropathy.Methods Selected 60 cases of patients with diabetic nephropathy who were treated in our hospital from January 2015 to December 2017, divided into two groups randomly. The control group was treated with spironolactone, and the observation group was given oral administration of sitagliptin.Results After treatment, the effective rate of the observation group was significantly higher than control group (P<0.05). After treatment, the two groups of 24h urine protein quantitative and urinary albumin excretion rate were significantly less than before treatment, and the observation decreased more significantly (P<0.05). However, there was no significant difference in serum creatinine and blood urea nitrogen between the two groups. The levels of TG, LDL-C and TC in the two groups were significantly decreased (P<0.05), and the HDL-C level increased significantly (P<0.05), and the improvement in the observation group was more significant (P<0.05).Conclusion The combination of spironolactone and sitagliptin can help to improve the therapeutic effect of diabetic nephropathy, improve renal function and control the level of blood lipid, which is worthy of application.