2型糖尿病并重症肾衰竭连续肾脏替代治疗临床效果及对血清瘦素和微小RNA-30a水平的影响  

Clinical Efficacy of Continuous Renal Replacement Therapy for Type 2 Diabetes Mellitus Complicated with Severe Renal Failure and its Effect on Serum Leptin and MiR-30a Levels

作　　者：马晓华 周亚男[2] 王荣荣[2] 聂屾[1] 李石磊 王博[1] 李勇[1] MA Xiao-hua;ZHOU Ya-nan;WANG Rong-rong;NIE Shen;LI Shi-lei;WANG Bo;LI Yong(Department of Emergency Medicine,the Central Hospital of Cangzhou,Cangzhou,Heibei 061001,China;the First Department of Endocrinology,the Central Hospital of Cangzhou,Cangzhou,Heibei 061001,China)

机构地区：[1]沧州市中心医院急诊医学部,河北沧州061001 [2]沧州市中心医院内分泌一科,河北沧州061001

出　　处：《临床误诊误治》2019年第2期45-49,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省卫计委科研基金项目(20181532)

摘　　要：目的观察2型糖尿病并重症肾衰竭连续肾脏替代治疗临床效果及对血清瘦素和微小RNA-30a(miR-30a)水平的影响。方法选取2型糖尿病并重症肾衰竭64例,根据透析方法不同将其分为观察组和对照组两组各32例。观察组给予连续肾脏替代治疗,对照组给予普通血液透析治疗。观察比较两组治疗后临床效果,治疗前后血糖指标、血清瘦素、肾功能指标、血清miR-30a水平,以及治疗期间不良反应发生情况。结果治疗后,观察组总有效率为90. 63%,对照组总有效率为75. 00%,观察组明显高于对照组,差异有统计学意义(P <0. 05)。治疗前,两组血糖指标、血清瘦素、肾功能指标、血清miR-30a水平比较差异均无统计学意义(P> 0. 05)。治疗后,观察组空腹血糖(FPG)、糖化血红蛋白(HbA1c)水平及血清瘦素水平均明显低于治疗前,对照组血清瘦素水平明显低于治疗前,观察组FPG、Hb A1c水平及血清瘦素水平均明显低于对照组,差异有统计学意义(P <0. 05)。治疗后,两组血清尿素(BUN)、肌酐(Scr)及miR-30a水平均较治疗前明显下降,观察组血清BUN、Scr及miR-30a水平明显低于对照组,差异有统计学意义(P <0. 05)。两组治疗期间均未出现低血压、心律失常、出血、感染及透析器凝血等不良反应。结论 2型糖尿病并重症肾衰竭患者连续肾脏替代治疗效果良好,并可控制血糖指标和血清瘦素水平,同时可改善肾功能指标、降低血清miR-30a水平。Objective To observe the clinical effects of continuous renal replacement therapy(CRRT)for type 2 diabetes mellitus(T2DM)complicated with severe renal failure and its effect on serum leptin and serum microRNA-30a(miR-30a)levels.Methods Sixty-four patients with T2DM and severe renal failure were enrolled in this study.According to different dialysis methods,they were divided into observation group and control group,with 32 patients in each group.The observation group was given CRRT,and the control group was given general hemodialysis treatment.The clinical effects,index of blood glucose before and after treatment,serum leptin,index of renal function,serum miR-30a level,and the occurrence of adverse reactions during the treatment of the two groups were compared.Results After treatment,the total effective rate of the observation group was 90.63%,which was significantly higher than that of the control group(75.00%),and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in blood glucose index,serum leptin,renal function index and serum miR-30a level between the two groups(P >0.05).After treatment,the levels of fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c)and serum leptin in the observation group were significantly lower than those before treatment.The serum leptin level in the control group were significantly lower than that before treatment.The levels of FPG,HbA1c and serum leptin levels in the observation group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of serum urea(BUN),creatinine(Scr)and miR-30a in the two groups were significantly lower than those before treatment.The levels of the above indicators in the observation group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).There were no adverse reactions such as hypotension,arrhythmia,hemorrhage,infection and coagulation of dialyzer durin

关 键 词：糖尿病 2型 肾功能不全 肾替代疗法 治疗结果 瘦素 微小RNA-30a 

分 类 号：R587.1[医药卫生—内分泌] R692.5[医药卫生—内科学]