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目的观察甘精胰岛素联合二甲双胍治疗初发早期糖尿病肾病(DN)的临床疗效。方法 116例初发早期DN患者随机分成对照组和治疗组,每组各58例。对照组采用甘精胰岛素联合阿卡波糖控制血糖,治疗组采用甘精胰岛素联合二甲双胍控制血糖,两组患者均在控制血糖的基础上口服厄贝沙坦,疗程3个月。检测两组患者治疗前后的空腹血糖(Glu)、餐后2h血糖(2 hGlu)、糖化血红蛋白(HbA1c)、24h尿微量白蛋白(24hM-Alb)、超敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-ɑ(TNF-α),测量血压及计算体重指数(BMI),并进行分析比较。结果与治疗前比较,两组治疗后的Glu、2hGlu、HbA1c、24hM-Alb、hs-CRP、IL-6、TNF-ɑ、收缩压和舒张压均明显下降(P<0.05);与对照组比较,治疗组治疗后的24hM-Alb、hs-CRP、IL-6、TNF-ɑ、收缩压、舒张压和BMI均明显降低(P<0.05)。结论甘精胰岛素联合二甲双胍治疗初发早期DN取得更好的疗效,值得在临床推广应用。
Objective To observe the clinical efficacy of insulin glargine plus metformin in the treatment of early diabetic nephropathy (DN). Methods One hundred and sixty-one cases with early-onset DN were randomly divided into control group and treatment group, 58 cases in each group. The control group was treated with insulin glargine combined with acarbose to control blood sugar. The treatment group was given insulin glargine combined with metformin to control blood sugar. Both groups were given irbesartan for 3 months on the basis of controlling blood glucose. The fasting blood glucose (Glu), postprandial 2h glucose, HbA1c, 24hM-Alb and hs-CRP were measured before and after treatment in both groups. , Interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), blood pressure and body mass index (BMI) were measured and compared. Results Compared with those before treatment, the levels of Glu, 2hGlu, HbA1c, 24hM-Alb, hs-CRP, IL-6, TNF-ɑ, systolic pressure and diastolic pressure were significantly decreased The levels of hs-CRP, IL-6, TNF-ɑ, systolic blood pressure, diastolic blood pressure and BMI in the treatment group were significantly decreased after treatment (P <0.05). Conclusion Glargine and metformin treatment of early-onset early DN get better efficacy, it is worth in the clinical application.