胰岛素强化降糖对早期DN患者血糖、肾功能的影响评价(1)
【摘要】 目的：观察胰岛素强化降糖对早期糖尿病肾病(DN)患者血糖、肾功能的影响。方法：按随机数表法将66例早期DN患者分为胰岛素强化治疗组(研究组，n=33)和常规组(对照组，n=33)。观察两组患者治疗4周后血糖改善情况[空腹血糖(FPG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)]，于治疗前及治疗4周后检测两组患者肾功能相关指标[β2-微球蛋白(β2-MG)、尿白蛋白排泄率(UAER)、血肌酐(Scr)]、氧化应激指标[超氧化物歧化酶(SOD)、3-硝基酪氨酸(3-NT)、谷胱甘肽(GSH)]水平。结果：治疗后，两组FPG、2 h PBG、HbA1c、β2-MG、UAER、Scr、3-NT水平均较治疗前降低，且研究组低于对照组，差异均有统计学意义(P<0.05);两组SOD、GSH水平均较治疗前升高，且研究组高于对照组，差异均有统计学意义(P<0.05)。结论：胰岛素强化治疗在控制血糖、改善患者肾功能和氧化应激等方面较常规口服降糖药更具优势。
【关键词】 胰岛素强化降糖; 早期糖尿病肾病; 血糖; 肾功能
doi：10.14033/j.cnki.cfmr.2019.14.007 文献标识码 A 文章编号 1674-6805(2019)14-00-03
Effects Evaluation of Insulin-intensive Hypoglycemic Therapy on Blood Glucose and Renal Function in Patients with Early DN/XIE Yi.//Chinese and Foreign Medical Research，2019，17(14)：-18
【Abstract】 Objective：To observe the effects of insulin-intensive hypoglycemic therapy on blood glucose and renal function in patients with early diabetic nephropathy (DN).Method：A total of 66 patients with early DN were divided into intensive insulin treatment group (study group，n=33) and conventional group (control group，n=33) according to the random number table method.The blood glucose improvement [fasting plasma glucose (FPG)，postprandial 2 h blood glucose (2 h PBG)，glycosylated hemoglobin (HbA1c)]was observed in the two groups after 2 weeks of treatment，and the levels of renal function-related indicators[β2-microglobulin (β2-MG)，urinary albumin excretion rate (UAER)，serum creatinine (Scr)]and oxidative stress indexes [superoxide dismutase (SOD)，3-nitrotyrosine (3-NT)，glutathione (GSH) were detected in the two groups before treatment and after 4 weeks of treatment.Result：After treatment，the levels of FPG，2 h PBG，HbA1c，β2-MG，UAER，Scr and 3-NT in the two groups were lower than those before treatment，and the levels in study group were lower than those in control group (P<0.05).The levels of SOD and GSH in the two groups were higher than those before treatment，and the levels in study group were higher than those in control group (P<0.05).Conclusion：Intensive insulin treatment has advantages over conventional oral hypoglycemic agents in controlling blood glucose and improving renal function and oxidative stress.
【Key words】 Insulin-intensive hypoglycemic therapy; Early diabetic nephropathy; Blood glucose; Renal function
First-author’s address：Songzi People’s Hospital，Songzi 434200，China
糖尿病腎病(DN)作为糖尿病(DM)常见慢性并发症，其在10～20年病史DM患者中发病率约为50%[1]。DN进展至晚期或导致肾功能衰竭将对患者生存质量造成严重影响。早期DN尿微量蛋白水平升高反映肾脏血管受损，于此阶段治疗对延缓DN进展至关重要。严格控制血糖是DN综合治疗基础环节，且有文献显示，严格控制血糖可显著减少DM患者部分微血管并发症尤其是DN的发生率[2]。对此，本研究观察胰岛素强化降糖在早期DN中的应用情况，现报道如下。, 百拇医药(谢宜)
【关键词】 胰岛素强化降糖; 早期糖尿病肾病; 血糖; 肾功能
doi：10.14033/j.cnki.cfmr.2019.14.007 文献标识码 A 文章编号 1674-6805(2019)14-00-03
Effects Evaluation of Insulin-intensive Hypoglycemic Therapy on Blood Glucose and Renal Function in Patients with Early DN/XIE Yi.//Chinese and Foreign Medical Research，2019，17(14)：-18
【Abstract】 Objective：To observe the effects of insulin-intensive hypoglycemic therapy on blood glucose and renal function in patients with early diabetic nephropathy (DN).Method：A total of 66 patients with early DN were divided into intensive insulin treatment group (study group，n=33) and conventional group (control group，n=33) according to the random number table method.The blood glucose improvement [fasting plasma glucose (FPG)，postprandial 2 h blood glucose (2 h PBG)，glycosylated hemoglobin (HbA1c)]was observed in the two groups after 2 weeks of treatment，and the levels of renal function-related indicators[β2-microglobulin (β2-MG)，urinary albumin excretion rate (UAER)，serum creatinine (Scr)]and oxidative stress indexes [superoxide dismutase (SOD)，3-nitrotyrosine (3-NT)，glutathione (GSH) were detected in the two groups before treatment and after 4 weeks of treatment.Result：After treatment，the levels of FPG，2 h PBG，HbA1c，β2-MG，UAER，Scr and 3-NT in the two groups were lower than those before treatment，and the levels in study group were lower than those in control group (P<0.05).The levels of SOD and GSH in the two groups were higher than those before treatment，and the levels in study group were higher than those in control group (P<0.05).Conclusion：Intensive insulin treatment has advantages over conventional oral hypoglycemic agents in controlling blood glucose and improving renal function and oxidative stress.
【Key words】 Insulin-intensive hypoglycemic therapy; Early diabetic nephropathy; Blood glucose; Renal function
First-author’s address：Songzi People’s Hospital，Songzi 434200，China
糖尿病腎病(DN)作为糖尿病(DM)常见慢性并发症，其在10～20年病史DM患者中发病率约为50%[1]。DN进展至晚期或导致肾功能衰竭将对患者生存质量造成严重影响。早期DN尿微量蛋白水平升高反映肾脏血管受损，于此阶段治疗对延缓DN进展至关重要。严格控制血糖是DN综合治疗基础环节，且有文献显示，严格控制血糖可显著减少DM患者部分微血管并发症尤其是DN的发生率[2]。对此，本研究观察胰岛素强化降糖在早期DN中的应用情况，现报道如下。, 百拇医药(谢宜)