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目的:评估胰岛素强化治疗对早期糖尿病肾病的临床疗效。方法:选择2012年1月至2015年6月收治我科的早期糖尿病肾病患者94例,随机分为试验组和对照组。试验组(47例)给予胰岛素强化治疗,对照组(47例)应用口服降糖药治疗。比较两组治疗前和治疗30天后,患者空腹血糖、餐后血糖、糖化血红蛋白、尿蛋白排泄率、β_2微球蛋白和血肌酐的变化。结果:两组患者治疗后FBG、2h PBG、HbA1c、UAER及β_2-MG均显著降低,组内差异有统计学意义(P<0.05)。治疗后两组间比较,FBG、2h PBG、HbA1c差异无统计学意义(P>0.05),而UAER及β_2-MG差异有统计学意义(P<0.05)。结论 :应用胰岛素强化治疗早期糖尿病肾病,临床疗效确切,能有效控制血糖水平,改善肾功能,延缓糖尿病肾病的进展。
Objective: To evaluate the clinical effect of intensive insulin therapy on early diabetic nephropathy. Methods: A total of 94 patients with early diabetic nephropathy who were admitted to our department from January 2012 to June 2015 were randomly divided into experimental group and control group. The experimental group (47 cases) given insulin intensive treatment, the control group (47 cases) with oral hypoglycemic agents. The changes of fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin, urinary protein excretion rate, β_2 microglobulin and serum creatinine were compared between the two groups before treatment and after 30 days of treatment. Results: After treatment, FBG, 2h PBG, HbA1c, UAER and β_2-MG were significantly decreased in both groups. The difference was statistically significant (P <0.05). There were no significant differences in FBG, 2h PBG and HbA1c between the two groups after treatment (P> 0.05), but there was significant difference between UAER and β_2-MG (P <0.05). Conclusion: The application of insulin to strengthen the early diabetic nephropathy, clinical curative effect, can effectively control blood glucose levels, improve renal function, delay the progress of diabetic nephropathy.