2型糖尿病合并肾病40例临床治疗分析

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1、2型糖尿病合并肾病40例临床治疗分析doi：10.3969/j.issn.1007-614x.2014.16.21摘要目的：探讨2型糖尿病合并肾病临床治疗方法和疗效。方法：2013年2月-2014年2月收治2型糖尿病合并肾病患者40例，总结其临床特点，比较与非糖尿病肾病的区别。治疗时降糖药均选用普通胰岛素，每天餐前30分钟肌注。在此基础上，将患者分两组，分别加用毗格列酮和二甲双孤（治疗组）和单纯应用毗格列酮（对照组）治疗，治疗4个月，治疗前后分别测定24小时尿白蛋白排泄率、肾功等，比较疗效。结果：2型糖尿病合

2、并肾病患者比非糖尿病肾病蛋白尿出现时间早，总胆固醇、甘油三酯值低，24小时尿蛋白定量和肾小球滤过率差异不明显。治疗后，两组FBG、HbAlc、LDL-C、Fib、UAER等降低明显，HDL-C、ISI水平提高，ALT、Cr无显著变化，说明治疗组肾保护功能强,与对照组比较，差异有统计学意义。结论：2型糖尿病合并肾病与非糖尿病肾病病理特点有明显不同，临床应自行鉴别。治疗时，毗格列酮和二甲双肌联合应用疗效显著，更适合临床应用。关键词2型糖尿病肾病临床治疗Analysisoftheclinicaltreatmento

3、f40casesoftype2diabeticcombinedwithnephropathyXuShaofengTheThirdDepartmentofInternalMedicine,thePeople"sHospitalofFeixiCounty,Anhui231200AbstractObjective:Toexploretheclinicaltreatmentmethodsandcurativeeffectoftype2diabeticcombinedwithnephropathy.Methods：40

4、caseswithtype2diabeticcombinedwithnephropathywereselectedfromFebruary2013toFebruary2014.Theclinicalcharacteristicsweresummaried,andcomparedwithnondiabeticnephropathy.Thehypoglycemicdrugsfortreatmentwereallinsulin.Itwasintramuscularinjected30minutesbeforemea

5、lseveryday.Onthisbasis,thecasesweredividedintotwogroups・Theyweretreatedwithpioglitazonecombinedwithmetformin(thetreatmentgroup)andthesimpleapplicationofpioglitazonetreatment(thecontrolgroup)・Theyweretreatedfor4months.24hoursurinaryalbuminexcretionrateandren

6、alfunctionwererespectivelymeasuredbeforeandafterthetreatment.Thecurativeeffectswerecompared・ResuIts:Theoccurrencetimeofproteinuriaofpatientswithtype2diabeticcombinedwithnephropathywasearlierthanthatofthenon-diabeticrenaldisease.Thetotalcholesterolandtriglyc

7、eridevalueswerelowerthanthoseofthenon-diabeticrenaldisease・Thedifferencesof24hoursurinaryproteinquantitativeandglomerularfiltrationratewerenotobvious.Afterthetreatment,FBG,HbAlc,LDL~C,Fib,UAERofthetwogroupsdecreasedsignificantly.HDL~C,ISIlevelwereincreased.

8、ALT,Crhadnosignificantchange.Therenalprotectionfunctionofthetreatmentgroupwasstrong.Comparedwiththecontrolgroup,thedifferencehasstatisticalsignificance.Conelusion:Thepathologicalcharacteristicsbetweent