胰岛素皮下泵持续注射对2型糖尿病肾病疗效的研究

摘要

目的：探讨胰岛素皮下泵持续注射（CSII）在2型糖尿病肾病（DN）中的治疗效果。方法 DN患者90例，按照随机数字表法分为观察组和对照组，各45例，患者均给予健康教育、饮食指导、运动疗法等，在此基础上观察组给予CSII治疗，对照组给予多次皮下注射胰岛素（MSII）治疗，检测两组血糖指标和肾功能指标改善情况。结果治疗后HbA1c、餐后2h血糖（早中晚）及睡前血糖组间比较差异无统计学意义（P>0.05），观察组FBS水平低于对照组，差异有统计学意义（P<0.05），治疗后观察组β2微球蛋白、Ccr、ALb、mALb、Hcy、CysC水平均低于对照组，差异有统计学意义（P<0.05），两组治疗后FBS、HbA1c、餐后2h血糖（早中晚）、睡前血糖以及Ccr、ALb、mALb、Hcy、CysC水平均明显降低，与治疗前比较差异均有统计学意义（P<0.05）；观察组血糖达标时间、住院时间均短于对照组，胰岛素总用量少于对照组，差异有统计学意义（P<0.05）；观察组总用费、药费均高于对照组，差异有统计学意义（P<0.05）。结论 CSII治疗2型糖尿病肾病效果显著，短时间内明显降低血糖，改善肾功能指标，但费用相对较贵，患者需根据实际情况选择。%ObjectiveTo expore the effects of subcutaneous continuous infusion of insulin for diabetic nephropathy(CSII) for diabetic nephropathy(DN).Methods90 cases of DN patients in our hospital,according random number table,were divided into observation group and the control group,45 cases each other.All patients were given health education,dietary guidance,exercise therapy,and based on this methd,observation group received CSII therapy,and the control group received MSII treatment,detecting blood sugar and kidney function parameters to improve the situation.Results Before treatment,HbA1c,postprandial 2h blood glucose between(early,middle and late)and bedtime blood glucose after treatment after treatment group difference was not statistically significant(P>0.05),the observation group FBS level lower than the control group, the difference statistically significant(P<0.05),after treatment in the observation groupβ2-microglobulin,Ccr,ALb,mALb,Hcy,CysC levels were lower than the control group,the difference was statistically significant(P<0.05),after treatment FBS,HbA1c,postprandial 2h blood glucose(early,middle and late),and bedtime blood glucose Ccr,ALb,mALb,Hcy,CysC were significantly reduced compared with that before treatment differences were statistically significant(P<0.05);the observation group blood glucose time,hospitalization time was shorter than the control group,the total amount is less than the control group,insulin dosage,the difference was statistically significant(P<0.05);the observation group total expense,drugs were higher,the difference statistically significant(P<0.05).Conclusion CSII treatment of type 2 diabetic nephropathy has significant effect of significantly reducing blood sugar within a short time andimproving renal function,but the cost is relatively high,patients need to choose according to the actual situation.