瑞舒伐他汀联合门冬胰岛素治疗糖尿病肾病的疗效观察

Clinical efficacy of rosuvastatin combined with insulin aspart in treatment of diabetic nephropathy

目的观察瑞舒伐他汀联合门冬胰岛素治疗糖尿病肾病的临床疗效。方法选取2015年4月—2016年12月在广西壮族自治区第三人民医院治疗的糖尿病肾病患者68例,随机分为对照组和治疗组,每组各34例。对照组患者餐前30 min皮下注射门冬胰岛素注射液,0.5~1.0 U/(kg·d),3次/d,根据患者具体情况调整剂量;或每日睡前皮下注射门冬胰岛素注射液,起始剂量为6 U/d,根据次日晨起时血糖情况调整剂量。治疗组在对照组的基础上口服瑞舒伐他汀钙片,20 mg/d。两组患者均治疗2周。观察两组患者临床疗效,比较治疗前后两组患者血糖水平、血脂水平和肾功能指标。结果治疗后,对照组和治疗组的总有效率分别为70.6%、88.3%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组空腹血糖(FBG)、餐后2 h血糖(2 h PG)和糖化血红蛋白(Hb A1c)水平明显降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组Hb A1c水平明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组总胆固醇(TC)、三酰甘油(TG)和低密度脂蛋白胆固醇(LDL-C)水平明显降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组TC、TG和LDL-C水平明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者尿素氮(BUN)、血肌酐(Scr)和尿白蛋白排泄率(UAER)水平明显降低,同组治疗前后差异具有统计学意义(P<0.05);且治疗后治疗组BUN、Scr和UAER水平明显低于对照组,两组比较差异具有统计学意义(P<0.05)。结论瑞舒伐他汀联合胰岛素强化治疗糖尿病肾病可有效调节患者血脂、血糖水平,改善肾功能状况且安全性高。

Objective To analyze the clinical efficacy of rosuvastatin combined with insulin aspart in treatment of diabetic nephropathy. Methods Patients（68 cases） with diabetic nephropathy in the Third People＇s Hospital of Guangxi Zhuang Autonomous Region from April 2015 to December 2016 were randomly divided into control and treatment groups, and each group had 34 cases. Patients in the control group were subcutaneous injection administered with Insulin Aspart Injection 30 min before meal, 0.5 — 1.0 U/（kg·d）, three times daily, and adjusted the dose according to the patient＇s specific condition, or they were iv subcutaneous injection administered with Insulin Aspart Injection before retiring, the initial dose was 6 U/d, and adjusted the dose according to the morning blood sugar. Patients in the treatment group were po administered with Rosuvastatin Calcium Tablets on the basis of the control group, 20 mg/d. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the blood glucose, blood lipid and renal function indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 70.6% and 88.3%, respectively, and there were differences between two groups（P〈0.05）. After treatment, the FBG, 2 h PG, and Hb A1 c levels in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. After treatment, the Hb A1 c level in the treatment group was obviously lower than that in the control group, with significant difference between two groups（P〈0.05）. After treatment, the TC, TG and LDL-C levels in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And the TC, TG and LDL-C levels in the treatment group were more significantly lower than those in the control group, with significant difference between two groups（P〈0.05）. After treatment, the BUN, Scr and UAER levels in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. After treatment, the BUN, Scr and UAER levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups（P〈0.05）. Conclusion Rosuvastatin combined with insulin can effectively regulate blood lipids and blood glucose levels in treatment of diabetic nephropathy, and improve renal function with high safety.