胰岛素强化治疗联合己酮可可碱对2型糖尿病肾病患者肾功能和血小板参数的影响及疗效分析

Effects of intensive insulin therapy combined with pentoxifylline on renal function and platelet parameters in patients with type 2 diabetic nephropathy

目的观察胰岛素强化治疗联合己酮可可碱对2型糖尿病肾病患者的临床疗效的影响。方法将68例2型糖尿病肾病患者随机分为对照组和治疗组,每组34例。2组均给予常规饮食控制及运动疗法,并予以胰岛素强化治疗,血糖控制达标后开始本试验。治疗组在此基础上加用己酮可可碱缓释片。2个月后观察患者临床疗效。结果 2组治疗后尿ACR、肌酐、尿素氮、尿酸水平均低于治疗前,治疗组尿ACR、肌酐、尿素氮水平均低于对照组,差异均有统计学意义(P<0.05)。治疗组治疗后尿酸水平高于对照组,但差异无统计学意义(P>0.05)。2组治疗后PLT、MPV、PDW、PCT水平均低于治疗前,差异有统计学意义(P<0.05)。治疗组治疗后PLT、MPV、PDW、PCT水平均低于低于对照组,且治疗前后差值均低于对照组,差异均有统计学意义(P<0.05)。2组疗效比较,差异有统计学意义(U=2.057,P<0.05),治疗组总有效率高于对照组,差异有统计学意义(P<0.05)。结论胰岛素强化治疗联合己酮可可碱对2型糖尿病肾病患者临床症状有明显改善作用,且能够显著降低血小板参数水平,对防治2型糖尿病肾病的发生发展具有重要意义。

Objective To observe the effects of intensive insulin therapy combined with pentoxifylline on the clinical efficacy in patients with type 2 diabetic nephropathy. Methods A total of 68 patients with type 2 diabetic nephropathy were randomly divided into control group ( n =34) and treatment group ( n =34).The patients in both groups were treated by routine diet control and exercise therapy as well as intensive insulin therapy.After the blood glucose control was up to standard, the trial was started.On this basis the patients in treatment group was given oral pentoxifylline sustained-release tablets.After 2-month treatment the therapeutic effects were observed and compared between the two groups. Results After treatment,the levels of urinary ACR,creatinine,urea nitrogen and uric acid were decreased in both groups,as compared with those before treatment, moreover, the levels of urinary ACR,creatinine and urea nitrogen in treatment group were significantly lower than those in control group ( P <0.05).After treatment the levels of uric acid in treatment group was higher than that in control group,but there was no statistically significant difference between the two groups ( P >0.05).The levels of PLT,MPV,PDW and PCT levels in both groups were significantly lower than those before treatment ( P <0.05).After treatment the levels of PLT,MPV,PDW and PCT in treatment group were significantly lower than those in control group,moreover, the difference value before and after treatment in treatment group was significantly lower than that in control group ( P <0.05).In addition there were significant differences in the therapeutic effects between the two grousp ( U =2.057, P <0.05),and the total effective rate in treatment group was significantly higher than that in control group ( P <0.05). Conclusion Intensive insulin therapy combined with pentoxifylline can significantly improve the clinical symptoms of patients with type 2 diabetic nephropathy,and can significantly reduce the levels of platelet parameters,which is of great significance for the prevention and treatment of type 2 diabetic nephropathy.