糖尿病肾病患者不同分期的胰岛素抵抗及机体生化代谢变化  

Changes of Insulin Resistance and Biochemistry Biochemical Metabolism in Patients with Diabetic Kidney Disease at Different Stages

作　　者：赵玉强[1] 叶群丽[1] 何叶[2] 陆小琴[3] ZHAO Yuqiang;YE Qunli;HE Ye(Ya’an Vocational College,Ya’an City,Sichuan Province 625000)

机构地区：[1]雅安职业技术学院药学与检验学院,四川省雅安市625000 [2]四川省人民医院老年科 [3]雅安职业技术学院附属医院检验科

出　　处：《医学理论与实践》2020年第8期1227-1229,1232,共4页The Journal of Medical Theory and Practice

基　　金：雅安职业技术学院2018年重点课题(YZY2018SKA01)。

摘　　要：目的:探究糖尿病肾病患者不同时期的胰岛素抵抗及机体的生化代谢变化。方法:从2017年1月-2018年1月间医院收治的43例2型糖尿病患者为对照组,44例糖尿病肾病患者为观察组,根据《中国2型糖尿病防治指南》分期标准,将糖尿病肾病变化分为5期,两组均采取胰岛素治疗,分别研究血糖代谢生化指标(FBG、FINS、2hPG、IAI、HbA1c、FCP)、肾功生化指标(sCr、cCr)和血脂代谢生化指标(BMI、TC、TG、LDL-C)的变化情况。结果:观察组Ⅰ期中的FBG、FINS、2hPG、IAI、HbA1c、FCP、sCr、cCr、TC、TG、与LDL-C与对照组差异不显著,无统计学意义(P>0.05),但Ⅱ期、Ⅲ期、Ⅳ期、Ⅴ期与对照组差异显著,有统计学意义(P<0.05);观察组各分期的BMI与对照组相比差异不显著,无统计意义(P>0.05);观察组Ⅳ期的FBG、2hPG、HbA1c、FINS、sCr、TC、TG和LDL-C显著高于Ⅱ期、Ⅲ期、Ⅴ期,差异有统计学意义(P<0.05);观察组的Ⅳ期的IAI和cCr显著低于Ⅱ期、Ⅲ期、Ⅴ期,有统计学意义(P<0.05);观察组Ⅴ期的FCP显著高于Ⅱ期、Ⅲ期、Ⅳ期,差异有统计学意义(P<0.05)。结论:糖尿病肾病患者不同分期的胰岛素抵抗与机体糖代谢均呈现不同的变化特征,尤其是Ⅳ期IAI、cCr和FCP的指标变化明显。因此,根据其变化特征,合理的药物治疗及饮食调节,可以调节胰岛素抵抗与机体生化代谢紊乱进而减轻肾脏受到的损害。Objective:To investigate the changes of insulin resistance and biochemical metabolism in patients with diabetic kidney disease at different stages.Methods:From January 2017 to January 2018, 43 patients with type 2 diabetes mellitus treated in the hospital were selected as control group and 44 patients with diabetic kidney disease as observation group.According to the staging standard of the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes, the changes in diabetic kidney disease were divided into five stages based on the changes in the biochemical indexes of blood glucose metabolism(FBG,FINS,2 hPG,IAI,HbA1 c,FCP),renal function(sCr,cCr) and blood lipid metabolism(BMI,TC,TG,LDL-C).Results:FBG, FINS,2 hPG,IAI,HbA1 c,FCP,sCr,cCr,TC,TG and LDL-C showed no statistically significant differences between the observation group and the control group at stage Ⅰ(P>0.05), but statistically significant differences at stage Ⅱ,Ⅲ,Ⅳ and Ⅴ(P<0.05).No statistically significant difference was found in BMI between the observation group and the control group at each stage(P>0.05).In the observation group,FBG,2 hPG,HbA1 c,FINS,sCr,TC,TG and LDL-C at stage Ⅳ were significantly higher than those at stage Ⅱ,Ⅲ and Ⅴ(P<0.05),IAI and cCr at stage Ⅳ were significantly lower than those at stage Ⅱ,Ⅲ and Ⅴ(P<0.05),and FCP at stage Ⅴ was significantly higher than that at Ⅱ,Ⅲ and Ⅳ(P<0.05).Conclusion:Insulin resistance and glucose metabolism in patients with diabetic kidney disease at different stages show different change characteristics, especially IAI, cCr and FCP at stage Ⅳ were changed significantly.Therefore, according to the change characteristics, reasonable drug treatment and diet regulation can regulate insulin resistance and biochemical metabolic disorders of the body, thus reducing the damage to the kidney.

关 键 词：糖尿病 糖尿病肾病 分期 胰岛素抵抗 生化代谢 

分 类 号：R587.1[医药卫生—内分泌]