甘精胰岛素联合瑞格列奈治疗老年2型糖尿病肾病的临床疗效

摘要

目的 探讨甘精胰岛素联合瑞格列奈治疗老年2型糖尿病肾病的临床应用价值.方法 将2010年1月至2011年12月在上海市闵行区吴泾医院诊治的80例2型糖尿病肾病患者随机分为试验组和对照组,各40例.对照组给予皮下注射0.4 U/(kg·d)诺和灵30R治疗,每日2次,疗程12周;试验组则给予皮下注射0.2 U/(kg·d)甘精胰岛素(每日1次)+口服0.5 mg瑞格列奈(每日3次)治疗,疗程12周.观察和比较两组的临床疗效以及血压、血糖、肾功能水平的变化情况.结果 试验组总有效率为87.5%,对照组总有效率为62.5%,试验组的临床疗效明显优于对照组(P＜0.05);试验组患者治疗后的收缩压、空腹血糖、餐后2 h血糖、糖化血红蛋白指标水平均优于对照组(P＜0.05),尿素氮、血清肌酐、尿白蛋白排泄率均低于对照组(P＜0.05).结论 甘精胰岛素联合瑞格列奈治疗老年2型糖尿病肾病的临床效果显著.%Objective To investigate the clinical value of insulin glargine with repaglinide for the treatment of type 2 diabetic nephropathy of the elderly.Methods 80 cases of elderly type 2 diabetic nephropathy admitted to Shanghai Minhang District Wujing Hospital from January 2010 to December 2011 were randomly divided into two groups, control group( n =40 ) and treatment group( n =40 ).The control group was given novolin 30R 0.4 U/( kg·d ),2 times/d through hypodermic injection for 12 weeks; while the treatment group was given insulin glargine 0.2 U/( kg·d )( 2 times/d ) and repaglinide 0.5 mg ( 3 times/d ) through hypodermic injection for 12 weeks.The clinical effects and the changes of blood pressure, blood sugar,kidney function of the two groups were observed and compared.Results The total effective rate of the treatment group was 87.5% ,of the control group was 62.5% ,so the clinical effects in the treatment group was significantly better than the control group( P < 0.05 ).The level of SBP, FPG, 2hPG,HbAlc of the treatment group after treatment were significantly better than the control group( P <0.05 ).The level of BUN ,SCr, UAER of the treatment group after treatment were significantly less than the control group( P <0.05 ).Conclusion There is a significant clinical effect of insulin glargine with repaglinide for the treatment of type 2 diabetic nephropathy of the elderly.