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作为一类新型口服降糖药,二肽基肽酶4(DPP-4)抑制剂已广泛用于T2DM的治疗。近年来研究提示,DPP-4抑制剂可能具有独立于降糖效果以外的肾脏保护作用,部分临床研究显示,DPP-4抑制剂具有降低T2DM患者尿微量白蛋白(UMalb)、延缓肾病进展的效应,基础研究表明其肾脏保护的机制可能涉及抗炎、抗氧化、改善内皮细胞功能等作用。而目前DPP-4抑制剂降低UMalb方面的数据主要来源于动物实验和少量小样本临床观察,因而仍有必要开展更多更严谨的大型随机对照(RCT)研究,验证其肾脏保护作用。本文对DPP-4抑制剂在肾脏保护,尤其是改善UMalb方面的研究进展做一综述。
As a new class of oral hypoglycemic agents, dipeptidyl peptidase 4 (DPP-4) inhibitors have been widely used in the treatment of T2DM. Recent studies suggest that DPP-4 inhibitors may have renal protection independent of hypoglycemic effect. Some clinical studies have shown that DPP-4 inhibitors can reduce the urinary albumin (UMalb) in patients with T2DM and delay the progression of nephropathy , Basic research shows that its mechanism of renal protection may involve anti-inflammatory, anti-oxidant, improve endothelial cell function and so on. However, the current data on the reduction of UMalb by DPP-4 inhibitors mainly come from the clinical observation of animal experiments and a small number of small samples. Therefore, it is still necessary to conduct more and more rigorous large-scale randomized controlled trials (RCTs) to verify their renal protective effects. This article reviews the progress of DPP-4 inhibitors in kidney protection, especially the improvement of UMalb.