摘要
目的:探讨2型糖尿病合并肾病临床治疗方法和疗效。方法:2013年2月-2014年2月收治2型糖尿病合并肾病患者40例,总结其临床特点,比较与非糖尿病肾病的区别。治疗时降糖药均选用普通胰岛素,每天餐前30分钟肌注。在此基础上,将患者分两组,分别加用吡格列酮和二甲双胍(治疗组)和单纯应用吡格列酮(对照组)治疗,治疗4个月,治疗前后分别测定24小时尿白蛋白排泄率、肾功等,比较疗效。结果:2型糖尿病合并肾病患者比非糖尿病肾病蛋白尿出现时间早,总胆固醇、甘油三酯值低,24小时尿蛋白定量和肾小球滤过率差异不明显。治疗后,两组FBG、HbA1c、LDL-C、Fib、UAER等降低明显,HDL-C、ISI水平提高,ALT、Cr无显著变化,说明治疗组肾保护功能强,与对照组比较,差异有统计学意义。结论:2型糖尿病合并肾病与非糖尿病肾病病理特点有明显不同,临床应自行鉴别。治疗时,吡格列酮和二甲双胍联合应用疗效显著,更适合临床应用。
Objective:To explore the clinical treatment methods and curative effect of type 2 diabetic combined with nephropathy. Methods:40 cases with type 2 diabetic combined with nephropathy were selected from February 2013 to February 2014.The clinical characteristics were summaried,and compared with non diabetic nephropathy.The hypoglycemic drugs for treatment were all insulin.It was intramuscular injected 30 minutes before meals every day.On this basis,the cases were divided into two groups. They were treated with pioglitazone combined with metformin(the treatment group) and the simple application of pioglitazone treatment(the control group).They were treated for 4 months.24 hours urinary albumin excretion rate and renal function were respectively measured before and after the treatment.The curative effects were compared.Results:The occurrence time of proteinuria of patients with type 2 diabetic combined with nephropathy was earlier than that of the non-diabetic renal disease.The total cholesterol and triglyceride values were lower than those of the non-diabetic renal disease.The differences of 24 hours urinary protein quantitative and glomerular filtration rate were not obvious.After the treatment,FBG,HbA1c,LDL-C,Fib,UAER of the two groups decreased significantly.HDL-C,ISI level were increased.ALT,Cr had no significant change.The renal protection function of the treatment group was strong.Compared with the control group,the difference has statistical significance.Conclusion: The pathological characteristics between type 2 diabetic combined with nephropathy and non diabetic nephropathy are significantly different.They should self identification in clinical.During the treatment,pioglitazone combined with metformin has a obvious curative effect.It is suitable for clinical application.
关键词
2型糖尿病
肾病
临床治疗
Type 2 diabetic
Nephropathy
Clinical treatment
