二甲双胍对早期糖尿病肾病的治疗作用

Metformin treatment of early diabetic nephrophathy

目的:观察二甲双胍对早期糖尿病肾病的治疗作用并初探其机理。方法:32例早期糖尿病肾病患者经过2周的导入期后进入观察期,随机分为α-糖苷酶抑制剂组(α-Gls组)和二甲双胍组(Met组)。观察两组患者治疗前后体重指数(BMI)、空腹血糖(FPG)、糖化血红蛋白(HbA1C)、血清C反应蛋白(CRP)、纤维蛋白原(Fg)、尿微量白蛋白(mAlb)变化。结果:Met组治疗前后BMI、FPG、HbA1C变化明显:血CRP分别是(3.57±0.45)mg/L和(1.79±0.34)mg/L(P<0.05),血Fg分别是(4.79±0.57)g/L和(3.05±0.35)g/L(P<0.05),尿mAlb分别是(273±46.24)mg/24h和(104±35.11)mg/24h(P<0.05);α-Gls组治疗前后CRP、Fg、mAlb无明显变化。结论:二甲双胍可通过改善高凝状态、抗炎来治疗早期糖尿病肾病。

Objective To evaluate Metformin treatment of early diabetic nephrophathy and its mechanism. Method After induction period of two weeks, 32 patients with early diabetic nephrophathy were divided into α - glycosidase inhibitor group （ α - Gls group） and Metformln group （Met group）. The biochemical parameters including fasting plasma glucose （FPG）, glycosylated hemoglobin C （HbAlc）, C- reactive protein （CRP） , fibrinogen（Fg） , urine albumin （mAlb） and body mass index （BMI） were examined before and after therapy. Results CRP, Fg and mAlb in Met group before and after treatment showed significant difference （P 〈 0.05）. CRP was （3.57 ± 0.45 ） mg/L vs （ 1.79 ± 0. 34） mg/L; Fg was （4.79 ± 0.57 ） g/L vs （ 3.05 ± 0.35 ） g/L; mAlb was （ 273 ± 46.24） mg/24h vs （ 104 ± 35.11 ） mg/24h. There were no significant changes in CRP, Fg and mAlb in α - Gls group. Conclusion Metformin can treat early diabetic nephrophathy through lowing Fg and anti-inflammation.