瑞格列奈联合厄贝沙坦治疗2型糖尿病肾病的临床观察

CLINICAL VALUE OF REPAGLINIDE AND IRBESARTAN IN TREATMENT OF DIABETIC NEPHROPATHY

目的观察瑞格列奈及其联合厄贝沙坦治疗2型糖尿病肾病的临床疗效。方法将41例2型糖尿病肾病氮质血症期患者随机分为瑞格列奈组和瑞格列奈+厄贝沙坦组,瑞格列奈组20例,瑞格列奈+厄贝沙坦组21例。观察各组内及两组间治疗前后FBG、2hBG、HbA1c、UAER、BUN、Scr变化。结果经过治疗,两组FBG、2hBG、HbA1c均明显下降,治疗前后组内比较差异均有统计学意义(p<0.05)。两组FBG、2hBG组间比较无差异性(p>0.05)。瑞格列奈联合厄贝沙坦较瑞格列奈单独作用HbA1c下降明显,差异具有统计学意义(p<0.05),两组治疗前后组间UAER、BUN、Scr均无显著性差异(p>0.05)。两组低血糖发生率均低。结论瑞格列奈降糖疗效肯定;厄贝沙坦联用瑞格列奈更有效地降低血糖,对早期糖尿病肾病患者安全性和依从性良好。

Objective To evaluate the efficacy and safety of repaglinide and irbesartan in treatment of patients with diabetic nephmpathy. Methods Forty one patients with diabetic nephropathy （ in Azotemia period） were randomly divided into two groups. Twenty patients in the control group were treated with repaglinide. The other 21 patients in the trial group were treated with repaglinide combined with irbesartan. Both groups were under treatment for two months as a course, and the values of fasting blood glucose （FBG）, 2h postprandial blood glucose（2hBG）, glycosylated hemoglobin（ HbAlc ）, urinary albumin excretion rate（ UAER）, blood urea nitrogen（BUN） and serum creatinine（SCr） before and after the treatment were observed. The incidence of hypoglycemia of two groups was observed as well. Results After treatment, the levels of FBG, 2hBG, HbAI c in two groups all decreased obviously（p 〈 0. 05）, there was no statistical significance in the levels of FBG,2hBG between the two greups（p 〉0. 05 ） ,but there was statistical significance in the levels of HbAlc between the two groups（p 〈 0. 05 ）. However, the levels of UAER, BUN, SCr had no marked difference after the expefiment（p 〉 0. 05 ）. Patients in both two groups had few hypoglycemic episodes. Conclusion Repaglinide can control the blood glucose effectively in patients with diabetic nephropathy. Repaglinide and irbesartan in combination therapy is superi-or to monotherapy in glycemic control, and has high safety and good compliance in patients with early diabetic nephropathy.