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糖尿病肾病作为糖尿病最主要微血管并发症之一,不仅是发达国家终末期肾病(ESRD)的首要病因,也是中国ESRD的第2位病因;近年来多项试图证实强化血糖控制有益的临床试验表明,针对不同人群、不同降糖方案的强化降糖治疗均有改善尿蛋白的显著优势,但同时存在低血糖、心血管疾病相关死亡等方面的风险,糖尿病强化降糖治疗的性价比仍值得商榷;本文结合临床试验的结果,探讨强化降糖治疗的个体化、时机和目标值等问题。
Diabetic nephropathy, one of the most important microvascular complications of diabetes mellitus, is not only the primary cause of end-stage renal disease (ESRD) in developed countries but also the second cause of ESRD in China. In recent years, a number of clinical trials trying to confirm the beneficial effects of intensive glycemic control show that, Intensive hypoglycemic therapy for different population and different hypoglycemic regimens all have the obvious advantages of improving urinary protein, but there are also risks associated with hypoglycemia and cardiovascular disease-related death. The cost-effectiveness of intensive diabetes mellitus is still debatable. Combined with the results of clinical trials to explore the intensification of antihypoglycemic treatment of individual, timing and target value and other issues.