不同降血糖方法对糖尿病肾脏病患者血糖及尿蛋白排泄率的影响

Effect of different blood glucose-lowering methods on blood glucose fluctuations and urine protein excretion rate in early-middle stage diabetic nephropathy

目的 比较早期糖尿病肾脏病患者接受不同降血糖方法治疗后血糖波动及尿蛋白排泄率（UAER）情况,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 选择128例糖尿病肾脏病患者,入选时肾小球滤过率（GFR）处于慢性肾脏病（CKD）1～3期,分为A组60例、B组68例；分别给予胰岛素治疗和非胰岛素治疗,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 A组血糖漂移度较B组显著降低（P＜0.05）A、B组UAER分别为（82.5±19.6）μg/min和（65.7±21.1） μg/min,2组比较有统计学差异（P＜0.05）.结论 应用胰岛素治疗能更好控制血糖水平,有效减缓肾脏病变进展速度,是预防及治疗糖尿病肾脏病的有效方法.

Objective Compare the efficacy of different blood glucose-lowering methods on the blood glucose fluctuations and urine protein excretion rate in the early stage of diabetic nephropathy, and evaluate the preventive and therapeutic effect of insulin therapy on disease progression. Methods 128 patients with diabetic nephropathy at CKD 1-3 phases estimated by GFR were divided into two groups. Group A （n = 60） was given insulin therapy. Group B （n = 68） was given non-insulin treatment. The efficacy of different blood glucose-lowering methods and influencing factors were analyzed. Results The blood glucose excursion in group A was significantly lower than in group B （P〈0. 05）. There was significant difference in UAER between two groups （P〈0.05）. Conclusions Insulin therapy can control the level of blood glucose better and effectively slow the progress of kidney disease. Insulin therapy is an effective treatment for diabetic nephropathy.