那格列奈在治疗2型糖尿病早期肾病中的应用

Application of Nateglinide in Treatment of Type 2 Diabetes Accompanied with Early Nephropathy

目的探讨那格列奈治疗2型糖尿病并发早期肾病的疗效和安全性。方法将重庆市第六人民医院2008年2月-2010年4月诊断为2型糖尿病早期肾病的125例患者,随机分为治疗组(n=63)和对照组(n=62),治疗组予以那格列奈治疗,对照组予以诺和灵R治疗,疗程均为8周。监测所有患者治疗前后空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)2、4 h尿微量白蛋白定量(24 hU-A),以及低血糖发生例数。结果所有患者治疗8周后FPG2、hPG、HbA1c、24 hU-A水平均较治疗前显著下降(P<0.05)。治疗结束后诺和灵R组FPG、2 hPG、HbA1c水平显著低于那格列奈组,但都处于理想水平;24 hU-A两组之间差异无统计学意义(P>0.05);那格列奈组低血糖发生率显著低于诺和灵R组(P<0.05)。结论那格列奈具有良好的降糖效果和肾功能保护作用,低血糖发生率低,是一种安全有效的2型糖尿病早期肾病治疗手段。

Objective To explore the efficacy and safety of nateglinide for type 2 diabetes accompanied with early nephropathy. Methods A total of 125 cases of type 2 diabetes accompanied with early nephropathy diagnosed in our hospital between February,2008 and April,2010 were randomly assigned to receive nateglinide（treatment group,n=63） or receive novolin R（control group,n=62）.The treatment course in the two groups was 8-week.FPG, 2hPG,HbA1c,24hU-A and cases of hypoglycemia of all patients were recorded before and after the treatment. Results All patients had a significant decrease on those indexes after 8 weeks treatment（P0.05）.The indexes of FPG,2hPG,HbA1c in control group were significantly lower than those in treatment group（P0.05）,but all of them were with satisfied levels.No statistically significant difference was found in 24hU-A between the two groups after the treatment（P0.05）.The incidence rate of hypoglycemia in control group was significantly higher than that in treatment group（P0.05）. Conclusions Nateglinide has a better effect on decreasing blood sugar level and protecting kidney and reducing the incidence rate of hypoglycemia.It is an efficient and safe therapy for type 2 diabetes accompanied with early nephropathy.