2型糖尿病不同治疗方法与C肽肾小球滤过率的关系研究

Different treatments of 2 Diabetes and C-peptide glomerular filtration rate in different treatments

目的了解2型糖尿病C肽与肾小球滤过率在不同降糖方法中有何不同。方法回顾分析2011年6月-2013年6月在该院内分泌门诊就诊的385例2型糖尿病患者,检测其血糖、糖化血红蛋白、肾功能、C肽、计算肾小球滤过率,根据不同降糖方法分为4组：A组为非促泌剂组77例,B组为促泌剂组144例,C组为单用胰岛素组79例,D组为胰岛素加非促泌剂组85例;根据C肽浓度再分组：FC〈1.5为a组,FC1.5~3.5为b组,FC〉3.5为c组,PC〈6为d组,PC6~9为e组,PC〉9为f组,并对研究数据进行处理。结果糖化血红蛋白：A0.05）。肌酐：AB〉D〉C,A、B 2组与C、D 2组之间之间差异有统计学意义（P〈0.01）,但A组和B组,C组和D组之间差异无统计学意义（P〉0.05）。空腹C肽浓度：A〉B〉C〉D,餐后C肽浓度：B〉A〉C〉D,A、B 2组与C、D 2组之间之间差异有统计学意义（P〈0.01）,但A组和B组,C组和D组之间差异无统计学意义（P〉0.05）。肌酐为b〉c〉a,e〉d〉f,但两两之间差异无统计学意义（P〉0.05）;

Objective To investigate the different Hypoglycemic action between Type 2 diabetes C-peptide and glomerular fihration rate. Methods Retrospective analyze 385 T2DM（Type 2 Diabetes MeUitus） patients who was getting treatment in the endocrinology clinic in our hospital in recent two years（ During June. 2011 to June. 2013 ）. Main testing items including the T2DM patientsblood glucose, HbA1 C, renal function, C peptide, calculate GFR （ glomerular filtration rate）. According to different hypoglycemic therapy, the patients has been divided into four groups：Group A,77 T＇2DM patients （male 39, female 38） using non-insulin secretagogues. Group B, 144 T2DM patients （ male 78, female 66 ） using insulin secretagognes, Group C,79 T2DM patients （ male 45, female 39） only using insulin ; Group D, 85 T2DM patients （ male 45, female 40） using insulin and non-insulin secretagognes. Meanwhile based on the concentration of C peptide, we divide the T2DM patients into Group a, FC 〈 1.5 ; Group b, FC1.5 - 3.5 ; Group c, FC 〉 3.5 ; Group d, PC 〈 6 ; Group e, PC6 - 9 ; Group f, PC 〉 9. Process all the research data. Results Glycosylated hemoglobin： A 〈 B 〈 C 〈 D. Test results between Group A, B and Group C, D has sta- tistically significant difference Group C and D （ P 〉 0.05 ）. Creatinine ： A 〈 B 〈 D 〈 C. The results between every two groups have statistically significant difference （P 〈 0.05 ）. GFR （ glomerular filtration rate） ： A 〉 B 〉 D 〉 C. Test results Test results between Group A, B and Group C, D has statistically significant difference （P 〈 0.01 ）, but there is no statistically significant difference between Group A and B, Group C and D （P 〉 0.05 ）. Fasting c-peptide concentrations ： A 〉 B 〉 C 〉 D. Postprandial c-peptide concentrations B 〉 A 〉 C 〉 D, Test results between Group A, B and Group C, D has statistically significant difference （ P 〈 O. 01 ）, but there is no statistically significant difference between Group A and B, Group C and D （ P 〉 0.05 ）. Creatinine： b 〉 c 〉 a, e 〉 d 〉 f. But test results between every two groups have no statistically difference（ P 〉 0.05 ）. GFR（ glomerular filtration rate） ：a 〈 b 〈 c, a 〈 e 〈 f. The results between every two groups have statistically significant difference （P 〈 0.01 ）. Conclusion Duration of diabetes, glycemic control negatively correlated with C-peptide levels. GFR （ Glomerular Filtration Rate） positively correlated with C-peptide levels. Oral medicine, especially insulin secretagogues,does help to keep residual function of islet cells. Meanwhile, C-peptide can be the protection of diabetic microvascular and prevent the complications of diabetes.