双歧杆菌三联活菌肠溶胶囊联合己酮可可碱对老年早期糖尿病肾病患者肾功能和预后的影响  

Effects of bifidobacterium triple viable enteric coated capsule combined with pentoxifylline on renal function and prognosis in elderly patients with early diabetic nephropathy

作　　者：王晓迪 高玉涛 卢旭东 Wang Xiaodi;Gao Yutao;Lu Xudong(Department of Endocrinology and Gastroenterology,the Eighth People′s Hospital of Hebei Province,Shijiazhuang 050000,China)

机构地区：[1]河北省第八人民医院内分泌消化科,石家庄050000

出　　处：《中国医师进修杂志》2023年第11期1020-1026,共7页Chinese Journal of Postgraduates of Medicine

基　　金：河北省2020年度医学科学研究课题计划(20200708)。

摘　　要：目的探究双歧杆菌三联活菌肠溶胶囊联合己酮可可碱对老年早期糖尿病肾病患者肾功能和预后的影响。方法回顾性分析2020年5月至2022年5月河北省第八人民医院110例并发早期糖尿病肾病的老年2型糖尿病(T2DM)患者的临床资料。患者均给予常规饮食控制、运动疗法及胰岛素治疗,在此基础上,采用己酮可可碱治疗55例(对照组),双歧杆菌三联活菌肠溶胶囊联合己酮可可碱治疗55例(研究组)。治疗3个月后评估疗效,记录不良反应。分别于治疗前和治疗1、3个月后检测血糖指标,包括空腹血糖(FBG)、餐后2 h血糖(2 h PBG)和胰岛素敏感性指数(Matsuda指数);肾功能指标,包括尿素氮、肌酐和尿微量白蛋白排泄率(UAER);肠道菌群数量,包括双歧杆菌、乳杆菌、肠球菌和大肠埃希菌;炎性反应-应激指标,包括白细胞介素-6(IL-6)、转化生长因子-β_(1)(TGF-β_(1))、丙二醛和活性氧。结果治疗3个月后,研究组总有效率明显高于对照组[94.55%(52/55)比81.82%(45/55)],差异有统计学意义(χ^(2)=4.27,P<0.05);研究组与对照组不良反应发生率比较差异无统计学意义[3.64%(2/55)比10.91%(6/55),χ^(2)=1.21,P>0.05]。两组治疗前各检测指标比较差异无统计学意义(P>0.05)。研究组治疗1和3个月后FBG和2 h PBG明显低于对照组,Matsuda指数明显高于对照组,差异有统计学意义(P<0.01)。研究组治疗1和3个月后肌酐、尿素氮和UAER明显低于对照组,差异有统计学意义(P<0.01)。研究组治疗1和3个月后双歧杆菌和乳杆菌数量明显高于对照组,肠球菌和大肠埃希菌数量明显低于对照组,差异有统计学意义(P<0.01或<0.05)。研究组治疗1和3个月后IL-6、TGF-β_(1)、丙二醛和活性氧明显低于对照组,差异有统计学意义(P<0.01)。结论双歧杆菌三联活菌肠溶胶囊联合己酮可可碱治疗老年早期糖尿病肾病疗效确切,安全性高,能有效控制血糖水平,改善肾功能,这可能与Objective To explore the effect of bifidobacterium triple viable enteric coated capsule combined with pentoxifylline on renal function and prognosis in elderly patients with early diabetic nephropathy.Methods The clinical data of 110 elderly patients with type 2 diabetes mellitus(T2DM)complicated with early diabetes nephropathy in Hebei Eighth People′s Hospital from May 2020 to May 2022 were retrospectively analyzed.All patients were given routine dietary control,exercise therapy and insulin therapy.On this basis,55 patients were treated with pentoxifylline(control group),and 55 patients were treated with bifidobacterium triple viable enteric coated capsule combined with pentoxifylline(study group).The efficacy 3 months after treatment was evaluated,and the adverse reactions were record.Before treatment and after 1 and 3 months of treatment,the blood glucose indexes(including fasting blood glucose,FBG;2 h postprandial blood glucose,2 h PBG;insulin sensitivity index,Matsuda index),renal function indexes(including urea nitrogen;creatinine;urinary microalbumin excretion rate,UAER),intestinal flora amount(including bifidobacterium,lactobacillus,enterococcus and escherichia coli)and inflammatory response stress indexes(including interleukin-6,IL-6;transforming growth factorβ_(1),TGF-β_(1);malondialdehyde;reactive oxygen species)were measured.Results Three months after treatment,the total effective rate in study group was significantly higher than that in control group:94.55%(52/55)vs.81.82%(45/55),and there was statistical difference(χ^(2)=4.27,P<0.05).There was no statistical difference in the incidence of adverse reactions between study group and control group:3.64%(2/55)vs.10.91%(6/55),χ^(2)=1.21,P>0.05.There were no statistical differences in all indexes before treatment between study group and control group(P>0.05).The FBG and 2 h PBG after 1 and 3 months of treatment in study group were significantly lower than those in control group;while the Matsuda index was significantly higher than that in control gro

关 键 词：糖尿病肾病 老年人 己酮可可碱 预后 双歧杆菌三联活菌肠溶胶囊 肾功能 肠道菌群 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]