新诊断2型糖尿病患者尿ACR的筛查和达格列净的干预观察  

Screening and intervention observation of urinary ACR in newly diagnosed type 2 diabetes patients

作　　者：周小智[1] 符金香 郭剑平[1] 颜迪恩 郑欢欢 王梅丽 肖卫平[1] 肖黎明[1] ZHOU Xiao-zhi;FU Jin-xiang;GUO Jian-ping(Ji'an Central People's Hospital,Ji'an 343000,Jiangxi)

机构地区：[1]吉安市中心人民医院内分泌科,江西吉安343000

出　　处：《安徽医专学报》2022年第5期31-33,共3页Journal of Anhui Medical College

基　　金：吉安市指导性科技计划项目(编号:吉市科技字[2021]8号)。

摘　　要：目的:对新诊断2型糖尿病患者的尿微量白蛋白/肌酐比值(UACR)进行调查分析,并探讨达格列净对尿UACR增高患者的疗效。方法:选择在某医院就诊的新诊断2型糖尿病患者326例,对其进行UACR筛查,以UACR≥30 mg/mmol为UACR增高组,UACR<30 mg/mmol为UACR正常组,比较两组临床指标,将80例UACR增高患者分为二甲双胍治疗组(40例)和达格列净治疗组(40例),两组均予以生活方式干预,观察其治疗12周后疗效变化。结果:新诊断2型糖尿病患者UACR增高的患病率为24.54%,其中UACR增高组糖化血红蛋白(HbA1C)、空腹血糖(FBG)、体质指数(BMI)、收缩压(SBP)、舒张压(DBP)较UACR正常组显著增高。对UACR增高2型糖尿病患者进行达格列净治疗12周后,其空腹血糖、糖化血红蛋白、SBP、DBP、体质量(W)、UACR、尿酸(UA)显著降低,且与二甲双胍治疗组相比,达格列净治疗组的UACR、收缩压、尿酸显著降低。结论:新诊断2型糖尿病患者常合并UACR增高,故应进行常规筛查,对UACR增高的新诊断2型糖尿病患者进行达格列净的干预不仅能降低血糖,还可降低UACR,兼有降压、降体质量及降尿酸的作用,较二甲双胍更有优势。Objective:This paper investigates and analyzes the urinary microalbumin/creatinine ratio(UACR)in patients with newly diagnosed type 2 diabetes mellitus,and to explore the efficacy of daagligin in the treatment of patients with increased UACR.Methods:326 newly diagnosed type 2 diabetes patients admitted to our hospital were selected for UACR screening.Patients with UACR≥30 mg/mmol were divided into UACR Increased Group while UACR<30 mg/mmol were put into UACR Normal Group.Clinical indicators of the two groups were compared.80 patients with increased UACR were treated in Metformin Treatment Group(n=40)and Dagagligin Treatment Group(n=40),respectively.Lifestyle intervention was performed in both groups,and the therapeutic effects were observed after 12 weeks of treatment.Results:The prevalence rate of increased UACR in newly diagnosed type 2 diabetes patients was 24.54%,and the HbA1C,FBG,BMI,SBP and DBP in patients with increased UACR were significantly higher than those in Normal UACR Group.After 12 weeks of Dagagliptin Treatment,fasting blood glucose,hBA1c,SBP,DBP,body weight(W),UACR and uric acid(UA)in type 2 diabetes patients with increased UACR were significantly decreased,and UACR,systolic blood pressure and uric acid were significantly decreased in the Dagagliptin Treatment Group compared with the metformin treatment group.Conclusion:Patients with newly diagnosed type 2 diabetes often have increased UACR,so routine screening should be carried out.Dagagligin intervention for patients with newly diagnosed type 2 diabetes with increased UACR can reduce both blood glucose and UACR,and lower blood pressure,body weight and uric acid,which is more superior than metformin.

关 键 词：糖尿病 2型 UACR 达格列净 

分 类 号：R587.1[医药卫生—内分泌]