不同降糖方法在糖尿病肾病患者中的治疗效果及其对血管内皮功能的影响  

Effects of Different Hypoglycemic Methods on Diabetic Nephropathy Patients and Their Effects on Vascular Endothelial Function

作　　者：张素玲 ZHANG Su-ling(The Second Department of Internal Medicine Fengshun County People＇s Hospital,Fengshun,Guangdong,514300,China)

机构地区：[1]丰顺县人民医院内二科,广东丰顺514300

出　　处：《黑龙江医学》2018年第10期983-984,986,共3页Heilongjiang Medical Journal

基　　金：梅州市科技计划项目(2016B141)

摘　　要：目的观察合并不同类型糖尿病患者在不同方法干预后的血管内皮功能的变化。方法本项目研究纳入糖尿病肾病早期(A组)、临床糖尿病肾病期(B组)、糖尿病不合并肾病(C组)三组患者,每组患者50例。对比分析三组患者治疗前后体重、BMI、血压、血脂、胰岛素抵抗指数、尿肌酐、尿白蛋白、肾小球率过滤、血糖达标率、血糖波动情况等的差异。结果治疗前三组基线资料组间对比差异无统计学意义(P> 0. 05);血糖(FPG)、甘油三酯(TG)、血肌酐(SCr)均较治疗前略有下降,三组之间比较差异无统计学意义(P> 0. 05);较治疗前,治疗后空腹血糖(FBS)、糖化血红蛋白(Hb A1c)、高密度脂蛋白胆固醇(HDL-C)水平无明显改变,超敏c-反应蛋白(hs-CRP)、24 h尿白蛋白(24 h UAER)明显下降,肾小球滤过率(GFR)、内皮舒张功能(EDD)升高,差异有统计学意义(P <0. 05)。上述指标组间对比差异无统计学意义(P> 0. 05)。结论低蛋白质饮食+复方α酮酸用于不同类型糖尿病患者治疗效果显著,类似于缅沙坦,可有效改善血管内皮功能,减少尿白蛋白漏出,且安全性高,值得临床推广。Objective To observe the changes of different Upes of diabetic patients with vascular endothelial function in different methods of intervention. Methods This research included the early stage of diabetic nephropathy（ A group）, the clinical stage of diabetic nephropathy（ B group）and diabetes mellitus nephropathy（ C group）, with 50 eases of patients in each group before and after the comparative analysis. Weight, BMI, blood pressure, blood lipid, insulin resistance index, urinary ereatinine, urinary albumin, glomerular filtration rate, the standard rate of blood glucose and blood glucose fluctuation of three groups were compared. Results Before treatment, there was no significant difference in baseline data among three groups （P 〉 0. 05 ）. The blood glucose levels of FPG, triglyeeride TGN and serum ereatinine were slightly lower than those before treatment, and there was no significant difference a- mong three groups before treatment（P 〉 0. 05）. There was no significant change in the level of FBSN, HbAleN, HDL-C, HDL-C, hypersensitive e-reactive protein hs-CRPU and 24 h UAER-24 h urinary albumin, but the glomerular filtration rate （GFR） and en- dothelium-diastolie function（EDDD） inereased（P 〈 0. 05）. There was no significant difference among groups （ P 〉 0. 05 ）. Conclusion Compound alpha keto acid low protein diet for the treatment of different types of diabetes which were was similar to Burma Chastain, can effectively improve endothelial function and reduce urinary albumin leakage. It is of high safety, so it is worthy of promotion.

关 键 词：糖尿病 内皮功能 低蛋白质饮食 复方Α酮酸 

分 类 号：R587.1[医药卫生—内分泌]