摘要
目的:探讨二甲双胍联合骨化三醇对2型糖尿病患者肾功能及视网膜的保护作用。方法:80例2型糖尿病伴早期糖尿病肾病、轻中度非增生期视网膜病变患者采用随机数字表法分为对照组(40例)和观察组(40例)。对照组患者给予盐酸二甲双胍片,起始剂量为0.5 g/次,随餐服用(2次/d),每周增加0.5 g,逐渐增加至2 g/d。观察组患者在对照组治疗的基础上加用骨化三醇胶丸0.25μg/次,1次/d。两组均持续治疗并随访6个月。观察两组患者临床疗效,治疗前后血糖水平[2 h餐后血糖(2 h PG)、空腹血糖(FPG)]、肾功能指标[尿白蛋白与肌酐比值(ACR)、尿白蛋白排泄率(UAER)、尿蛋白定量(Pr)]与视力和视野缺损、眼底血管造影情况及不良反应发生情况。结果:观察组患者总有效率显著高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者2 h PG、FPG、ACR、UAER、Pr与视力和视野缺损、眼底血管造影情况比较,差异均无统计学意义(P>0.05)。治疗后,两组患者2 h PG、FPG、ACR、Pr、UAER、视野缺损平均值、眼底微血管数和出血面积均显著低于同组治疗前,且观察组低于对照组;视力显著高于同组治疗前,且观察组高于对照组,差异均有统计学意义(P<0.05)。两组患者治疗期间各有1例轻微不良反应。结论:二甲双胍联合骨化三醇对2型糖尿病患者肾功能及视网膜具有一定保护作用,能降低患者2 h PG、FPG、ACR、Pr、UAER、视野缺损平均值、眼底微血管数和出血面积,升高视力,且临床不良反应较小,安全性较高。
OBJECTIVE：To observe the protection effects of Metformin combined with Calcitriol on renal functiou and retina in patients with type 2 diabetes. METHODS：80 patients with type 2 diabetes with early diabetic nephropathy and mild-to-moderate non proliferative retinopathy were randomly divided into control group（40 cases）and observation group（40 cases）. Control group received Metformin hydrochloride tablet with initial dose of 0.5 g,twice a day during a meal,increased 0.5 g every week,then gradually increased to 2 g every day;observation group additionally received Calcitriol soft capsule,0.25 μg/times,once a day. The treatment lasted and followed-up for 6 months. Efficacy of retinopathy,blood glucose levels [2 h postprandial blood glucose（2 h PG）,blood glucose（FPG）],renal function indexes [urinary albumin-to-creatinine ratio（ACR）,urinary albumin excretion rate（UAER）,proteinuria（Pr）],vision and visual field defects,fundus angiography before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS：The total effective rate in observation group was significantly higher than in control group,and the difference was statistically significant（P〈0.05）. Before treatment,there were no significant differences in the 2 h PG,FPG,ACR,UAER,Pr,vision and visual field defects between 2 groups（P〈0.05）. After treatment,2 h PG,FPG were significantly lower than before;ACR,Pr,UAER,average value of visual field defects,fundus angiography and bleeding area were significantly lower than before,and observation group was lower than control group;vision was significantly higher than before,and observation group was higher than control group. The differences were statistically significant（P〈0.05）. There was respectively 1 patient showed slight adverse reactions in both groups. CONCLUSIONS：Metformin combined with Calcitriol has certain protection effect on the renal function and retina in patients with type 2 diabetes,it can reduce 2 h PG,FPG,ACR,Pr,UAER,a
出处
《中国药房》
CAS
北大核心
2016年第30期4227-4230,共4页
China Pharmacy
