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目的观察红花黄色素联合二甲双胍对早期糖尿病肾病(DN)患者氧化应激、胰岛素抵抗及肾功能的影响。方法选取2015年10月至2016年10月诊治的DN患者80例,随机分为对照组和观察组,每组40例。2组均接受常规治疗,对照组在常规治疗基础上口服盐酸二甲双胍治疗,观察组在对照组基础上静脉滴注红花黄色素,疗程均为2周。观察2组血清空腹血糖(FBG)、餐后2 h血糖(2 h PG)、胰岛素(FINS)、谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)、超氧化物歧化酶(SOD)、8异前列腺素F2α(8-iso-PGF2α)、胱抑素C(Cys C)、同型半胱氨酸(Hcy)、24 h尿蛋白量、尿白蛋白排泄率(UAER)变化,计算胰岛素抵抗指数(HOMA-IR)。结果与治疗前比较,2组治疗后FBG、2 h PG、FINS、HOMA-IR、MDA、Cys C、Hcy水平均较治疗前显著降低(P<0.05),GSH-Px、SOD水平均较治疗前显著升高(P<0.05),且观察组上述指标改善程度优于对照组(P<0.05)。结论红花黄色素联合二甲双胍治疗早期糖尿病肾病能够显著降低氧化应激水平,改善胰岛素抵抗,从而发挥肾脏保护作用。
Objective To observe the effects of safflor yellow combined with metformin on oxidative stress, insulin resistance and renal function in patients with early diabetic nephropathy (DN). Methods Eighty patients with DN who were diagnosed and treated from October 2015 to October 2016 were randomly divided into control group and observation group, 40 cases in each group. Both groups received routine treatment. The control group was treated with metformin hydrochloride on the basis of routine treatment. The observation group was treated with intravenous drip of safflower yellow on the basis of the control group for 2 weeks. The fasting blood glucose (FBG), 2 h PG, FINS, GSH-Px, MDA, superoxide (8-iso-PGF2α), cystatin C (Cys C), homocysteine (Hcy), 24 h urinary protein, urinary albumin excretion (UAER ) Changes, calculate the insulin resistance index (HOMA-IR). Results Compared with those before treatment, the levels of FBG, 2 h PG, FINS, HOMA-IR, MDA, Cys C and Hcy in both groups were significantly lower than those before treatment (P 0. 05) and GSH-Px and SOD (P <0.05), and the improvement of the above indexes in the observation group was better than that in the control group (P <0.05). Conclusion Safflower yellow combined with metformin in early diabetic nephropathy can significantly reduce the level of oxidative stress, improve insulin resistance, and thus play a protective role in the kidney.