海南医科大学学报

目的:比较不同降血糖方法治疗早期糖尿病肾病患者的疗效,探讨该期患者应用胰岛素治疗对于病程进展的预防及治疗作用。方法:选取128例糖尿病肾病患者,入选时肾小球滤过率处于CKD1³期,分为A、B两组,分别给予胰岛素治疗(包括胰岛素强化治疗、常规胰岛素治疗、胰岛素联合口服降糖药治疗)、非胰岛素治疗(口服降糖药治疗),对治疗结果进行分析比较,评判不同降血糖方法的疗效及影响因素。结果:128例糖尿病肾病患者经不同方法治疗后,总有效97例(75.8%),无效31例(24.2%);A组总有效52例(86.7%),B组总有效45例(66.2%),A、B两组总有效率差异有统计学意义(P<0.05)。治疗疗效与患者糖尿病病程、肾功能分期、年龄、血压、血脂相关(r分别为0.257、0.362、0.380、0.249、0.276,P均<0.05),与患者烟酒嗜好、性别情况无明显相关(r分别为1.242、1.516,P>0.05)。结论:应用胰岛素控制血糖能够有效减缓肾脏病变进展速度,是预防及治疗糖尿病肾病的有效方法。

Objective: To compare the efficacy of different hypoglycemic treatments on early diabetic nephropathy,and to evaluate the preventive and therapeutic effect of insulin.Methods: A total of 128 patients with diabetic nephropathy with glomerular filtration rate(GFR) at CKD1-3 phase were divided into two groups.Patients in Group A(n=60) were treated by insulin therapy(including intensified insulin therapy,conventional insulin therapy,combined therapy of insulin therapy and oral hypoglycemic drug treatment).While patients in Group B(n=68) were given non-insulin treatment(oral hypoglycemic drug treatment).The hypoglycemic efficacy was cmpared and impact factors were analyzed.Results:A total of 97 cases were effective(75.8%),31 cases were ineffective(24.2%),including 52 effective cases in Group A(86.7%) and 45 effective cases in Group B(66.2%).There was significant difference in total efficacy between two groups(P<0.05).The efficacy was related with course of diabetes,stage of renal function,age,blood pressure and blood lipid(r=0.257,0.362,0.380,0.249,0.276,respectively,and all P<0.05),but not related with tobacco and alcohol habits and sex(r=1.242,and 1.516,respectively,P>0.05).Conclusions: Insulin can effectively slow down the progress of kidney disease.It is effective on prevention and treatment of diabetic nephropathy.