甘精胰岛素联合瑞格列奈治疗2型糖尿病合并慢性肾功能不全疗效观察

Observation on Therapeutic Effect of Insulin Glargine in Combination with Repaglinide on Patients with Type 2 Diabetes Mellitus and Chronic Renal Insufficiency

目的分析甘精胰岛素联合瑞格列奈对2型糖尿病合并慢性肾功能不全的疗效以及不良反应。方法我院于2010-2011年共收治2型糖尿病合并慢性肾功能不全患者80例,随机分为对照组和实验组,每组40例,对照组给予瑞格列奈进行治疗,实验组给予甘精胰岛素联合瑞格列奈治疗。治疗12 W后对空腹血糖(FPG)、餐后2h血浆葡萄糖(2hPG)、糖化血红蛋白(HbA1c)、C肽(C-P)、血尿素氮(BUN)、血肌酐(SCr))、24h尿白蛋白排泄量(24hUAE)以及不良反应等指标进行分析。结果治疗后对照组和实验组FPG、2hPG、HbA1c、BUN、SCr以及24hUAE较治疗前均下降,但实验组较对照组下降更显著,且2组比较差异具有统计学意义(p<0.05);对照组和实验组治疗后C-P水平较治疗前增加,而实验组C-P水平高于对照组,且差异具有统计学意义(p<0.05)。两组不良反应发生率分别为17.5%和20%,差异无统计学意义(p>0.05)。结论甘精胰岛素联合瑞格列奈治疗2型糖尿病合并慢性肾功能不全疗效好于单用瑞格列奈,可有效控制患者血糖变化,同时对肾脏具有较好的保护作用。

Objective To analyze the clinical therapeutic effect and adverse reaction of insulin glargine in combination with repaglinide on type 2 diabetes mellitus and chronic renal insufficiency.Method 80 patients with type 2 diabetes mellitus and chronic renal insufficiency treated in our hospital from 2010 to 2011 were divided into experimental group and control group randomly with 40 cases in each group.The control group was treated with repaglinide while the experimental group was treated with insulin glargine and repaglinide.Indexes such as fasting plasma glucose（FPG）,2 h postprandial plasma glucose（2h PG）,glycosylated hemoglobin（HbA1c）,c-peptide（C-P）,blood urea nitrogen（BUN）,serum creatinine（SCr）,24 h urine albumin excretion（24h UAE） and the adverse reaction were analyzed after 12 weeks of treatment.Results FPG,2h PG,HbA1c,BUN,SCr and 24h UAE in experimental group and control group after the treatment were reduced compared with those before the treatment,but reduction in the experimental group was more prominent than that in the control group,and differences between the two groups were statistically significant（p0.05）;the C-P level in experimental group and control group after the treatment were increased compared with that before the treatment;C-P level in the experimental group was higher than that in the control group,and the differences were statistically significant（p0.05）.Incidence of adverse reaction in the two groups was 17.5% and 20% respectively,and the differences had no statistical significance（p0.05）.Conclusion The therapeutic effect of insulin glargine in combination with repaglinide in treating the type 2 diabetes mellitus and chronic renal insufficiency was better than that of the repaglinide,which can effectively control the blood glucose change in patients and meanwhile protect the kidney well.