复方α-酮酸(开同)片治疗对早期糖尿病肾病患者颈动脉内膜中层厚度的影响

Effect of Treatment of Compound α-Ketoacid Tablets(Kaitong) on Carotid Intima-media Thickness in Early Stage Patients with Diabetic Nephropathy

目的探讨复方α-酮酸(开同)片治疗早期糖尿病肾病患者对其颈动脉内膜中层厚度(carotid intima-media thickness,CIMT)的影响。方法将80例早期糖尿病肾病患者随机分为对照组(42例)和治疗组(38例)。对照组常规治疗,包括低蛋白饮食,治疗组在常规治疗的基础上进行复方α-酮酸(开同)片干预性治疗,疗程均为6个月。两组治疗前后进行体格检查,空腹抽静脉血,测定血尿酸(UA)、空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、胰岛素(FINS),测定CIMT和尿微量白蛋白排泄率(urinary micro albumen excretion rate,UAER)。结果治疗前两组患者各指标差异无统计学意义。治疗6个月后,治疗组患者FINS、稳态模型胰岛素抵抗指数(Homa-IR)、lnUAER、CIMT与治疗前及对照组治疗6个月后比较均明显下降(P<0.05);治疗组治疗前后CIMT差值大于对照组,差异有统计学意义(P<0.05)。通过协方差分析调整治疗组治疗前后血脂、血糖变化,治疗6个月后与治疗前比较,Homa-IR(F=2.60)、lnUAER(F=3.15)、CIMT(F=3.94)的差异仍然有统计学意义(P<0.05,P<0.01);治疗组治疗前后CIMT差值大于对照组(F=5.51)。结论复方α-酮酸(开同)片能有效改善早期糖尿病肾病患者胰岛素抵抗,长期治疗可降低微量白蛋白尿,并能减缓或阻止动脉粥样硬化的进展。

Objective To study the treatment effect of compound α-Ketoacid tablets （Kaitong）on carotid intimα-media thickness （CIMT） in the elderly patients with diabetic nephropathy （DN）. Methods 80 Chinese adults cases aged 20-75 yrs with DN were divided into two groups： （1） treatment group： 38 cases taking oral compound α-Ketoacid Tablets （Kaitong）, 3 times per day, continued for six month, （2）control group： 42 cases without medication, all patients were followed up for six months, and UAER was measured by RIA. Results FINS, Homα- IR, LnUAER in the treatment group were significantly lower than those in control group after six months treatment （P〈0.05）, and the difference of CIMT before and after treatment was higher in the treatment group than in the control （P〈0.05）. After adjustment with covariance analysis by blood lipids and blood glucose, the FINS, Homa-IR, LnUAER in treatment group were still statistically different before and after treatment （P 〈0.05）. Conclusion Compound α-Ketoacid tablets （Kaitong）reduced insulin resistance in the elderly patients with DN, and long-term treatment can reduce or hold level of microalbuminuria and delay the development of arteriosclerosis.