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目的探讨那格列奈治疗2型糖尿病并发早期肾病的疗效和安全性。方法将重庆市第六人民医院2008年2月-2010年4月诊断为2型糖尿病早期肾病的125例患者,随机分为治疗组(n=63)和对照组(n=62),治疗组予以那格列奈治疗,对照组予以诺和灵R治疗,疗程均为8周。监测所有患者治疗前后空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)2、4 h尿微量白蛋白定量(24 hU-A),以及低血糖发生例数。结果所有患者治疗8周后FPG2、hPG、HbA1c、24 hU-A水平均较治疗前显著下降(P<0.05)。治疗结束后诺和灵R组FPG、2 hPG、HbA1c水平显著低于那格列奈组,但都处于理想水平;24 hU-A两组之间差异无统计学意义(P>0.05);那格列奈组低血糖发生率显著低于诺和灵R组(P<0.05)。结论那格列奈具有良好的降糖效果和肾功能保护作用,低血糖发生率低,是一种安全有效的2型糖尿病早期肾病治疗手段。
Objective To investigate the efficacy and safety of nateglinide in the treatment of type 2 diabetes complicated with early nephropathy. Methods 125 patients diagnosed as type 2 diabetic nephropathy from February 2008 to April 2010 in Chongqing Sixth People’s Hospital were randomly divided into treatment group (n = 63) and control group (n = 62). The treatment group The patients were treated with nateglinide, while the control group was treated with Neohelin R for 8 weeks. Fasting plasma glucose (FPG), postprandial 2h glucose (HbA1c), 2,4 h urine microalbuminuria (24 hU-A), and the number of hypoglycemic episodes were monitored before and after treatment in all patients. Results The levels of FPG2, hPG, HbA1c and 24 hU-A in all patients after 8 weeks of treatment were significantly lower than those before treatment (P <0.05). The levels of FPG, 2 hPG and HbA1c in Novolin group after treatment were significantly lower than those in nateglinide group, but both were in the ideal level. There was no significant difference between the two groups (P> 0.05) The incidence of hypoglycemia in glenian group was significantly lower than that in norepinephrine group (P <0.05). Conclusion Nateglinide has a good hypoglycemic effect and renal function protection, low incidence of hypoglycemia, is a safe and effective treatment of type 2 diabetes early nephropathy.