胰岛素强化治疗对早期糖尿病肾病的疗效观察

Effects ofIntensive Insulin Therapy on Early Diabetic Nephropathy

目的观察胰岛素强化治疗对2型糖尿病合并早期糖尿病肾病(DN)的临床疗效。方法选取我院糖尿病早期肾病患者116例,A组给予胰岛素强化治疗,B组应用口服降糖药治疗。结果胰岛素强化治疗组治疗后尿白蛋白排泄率(UAER)、空腹血糖、餐后两小时血糖、糖化血红蛋白(GHbA1c)显著下降,空腹C肽及餐后2小时C肽显著升高,与治疗前及对照组比较均有统计学意义(P<0.05),其中逆转为正常蛋白尿14例;对照组上述指标治疗前、后比较无统计学意义(P>0.05),进展为临床期糖尿病6例。结论应用胰岛素强化治疗控制血糖水平,可能会改善糖尿病预后,延缓糖尿病肾病进展。

Objective To observe the clinical efficacy of intensive insulin therapy in type 2 diabetes with early diabetic nephropathy（DN）.Methods 116 patients with early diabetic nephropathy were divided into two groups,in which patients received intensive insulin therapy（Group A） and were treated with oral hypoglycemic agents（Group B）.The urinary albumin excretion rate（UAER）,fasting glucose,postprandial blood glucose,GHbA1c and C peptide were detected.Results The UAER,fasting glucose,postprandial blood glucose at two hours and GHbA1c in Group A decreased significantly,and the fasting C peptide and postprandial C peptide at 2 h were significantly higher that of before the treatment and group B（P0.05）.The proteinuria 14 cases of patients in group A were reversed to normal.These indicators before and after treatment in Group B showed no significantly difference（P0.05）,but 6 cases of patients in group B progressed to clinical diabetes.Conclusion Intensive insulin therapy could control blood sugar levels,improve the prognosis of diabetes and delay the progress of renal dysfunction.