糖尿病强化降糖治疗肾脏受益与相关风险  

Role of intensive glucose control in kidney benefit and related risk in diabetic patients

作　　者：张并璇[1,2] 严美花[2] 赵海玲[2] 李平[2] 

机构地区：[1]北京中医药大学,北京100029 [2]中日友好医院临床医学研究所

出　　处：《中国公共卫生》2016年第3期406-409,共4页Chinese Journal of Public Health

基　　金：国家"十二五"科技支撑计划项目(2013BAI02B04);科技部国际科技合作项目(2011DFA31860);国家自然科学基金重点项目(81130066)

摘　　要：糖尿病肾病作为糖尿病最主要微血管并发症之一,不仅是发达国家终末期肾病(ESRD)的首要病因,也是中国ESRD的第2位病因;近年来多项试图证实强化血糖控制有益的临床试验表明,针对不同人群、不同降糖方案的强化降糖治疗均有改善尿蛋白的显著优势,但同时存在低血糖、心血管疾病相关死亡等方面的风险,糖尿病强化降糖治疗的性价比仍值得商榷;本文结合临床试验的结果,探讨强化降糖治疗的个体化、时机和目标值等问题。As one of the most common microvascular complications of diabetes,diabetic kidney disease is not only the leading cause of end-stage renal disease（ ESRD） in developed countries,but also the second cause of ESRD in China.In recent years,a number of clinical trials attempting to prove the beneficial of intensive glucose control indicated that intensive blood glucose control therapy has the effect of improving urinary protein in different groups of patients. However,there exist the risks of hypoglycemia and cardiovascular diseases simultaneously. Thus,the risk reward ratio of intensive blood glucose control is still debatable. In this paper,we discuss the individualized treatment,the timing of intervention,the target of intensive glucose control therapy,and some other issues related to the results of these clinical trials.

关 键 词：糖尿病 强化降糖治疗 肾脏受益 风险 

分 类 号：R587.1[医药卫生—内分泌]