胰岛素强化降糖对早期DN患者血糖、肾功能的影响评价

Effects Evaluation of Insulin-intensive Hypoglycemic Therapy on Blood Glucose and Renal Function in Patients with Early DN

目的:观察胰岛素强化降糖对早期糖尿病肾病(DN)患者血糖、肾功能的影响。方法:按随机数表法将66例早期DN患者分为胰岛素强化治疗组(研究组,n=33)和常规组(对照组,n=33)。观察两组患者治疗4周后血糖改善情况[空腹血糖(FPG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)],于治疗前及治疗4周后检测两组患者肾功能相关指标[β_2-微球蛋白(β_2-MG)、尿白蛋白排泄率(UAER)、血肌酐(Scr)]、氧化应激指标[超氧化物歧化酶(SOD)、3-硝基酪氨酸(3-NT)、谷胱甘肽(GSH)]水平。结果:治疗后,两组FPG、2 h PBG、HbA1c、β_2-MG、UAER、Scr、3-NT水平均较治疗前降低,且研究组低于对照组,差异均有统计学意义(P<0.05);两组SOD、GSH水平均较治疗前升高,且研究组高于对照组,差异均有统计学意义(P<0.05)。结论:胰岛素强化治疗在控制血糖、改善患者肾功能和氧化应激等方面较常规口服降糖药更具优势。

Objective:To observe the effects of insulin-intensive hypoglycemic therapy on blood glucose and renal function in patients with early diabetic nephropathy(DN).Method:A total of 66 patients with early DN were divided into intensive insulin treatment group(study group,n=33)and conventional group(control group,n=33)according to the random number table method.The blood glucose improvement[fasting plasma glucose(FPG),postprandial 2 h blood glucose(2 h PBG),glycosylated hemoglobin(HbA1c)]was observed in the two groups after 2 weeks of treatment,and the levels of renal function-related indicators[β2-microglobulin(β2-MG),urinary albumin excretion rate(UAER),serum creatinine(Scr)]and oxidative stress indexes[superoxide dismutase(SOD),3-nitrotyrosine(3-NT),glutathione(GSH)were detected in the two groups before treatment and after 4 weeks of treatment.Result:After treatment,the levels of FPG,2 h PBG,HbA1c,β2-MG,UAER,Scr and 3-NT in the two groups were lower than those before treatment,and the levels in study group were lower than those in control group(P<0.05).The levels of SOD and GSH in the two groups were higher than those before treatment,and the levels in study group were higher than those in control group(P<0.05).Conclusion:Intensive insulin treatment has advantages over conventional oral hypoglycemic agents in controlling blood glucose and improving renal function and oxidative stress.