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目的观察胰岛素联合缬沙坦对早期糖尿病肾病的干预作用。方法 46例早期糖尿病肾病患者,30例采用胰岛素联合缬沙坦治疗(观察组),16例行常规口服降血糖药物治疗(对照组),比较2组治疗前、后患者空腹血糖、餐后2h血糖、糖化血红蛋白、尿微量白蛋白、肌酐、血压、血脂等水平。结果治疗3个月后观察组空腹血糖、餐后2h血糖逐渐恢复正常,且血糖波动较小,而对照组血糖水平有所下降,但波动较大;尿微量白蛋白及尿蛋白排泄率2组改变均不明显;治疗6个月观察组尿微量白蛋白及尿蛋白排泄率开始下降;治疗1a后观察组尿微量白蛋白及尿蛋白排泄率低于对照组(P<0.01),其中8例尿微量白蛋白达正常水平,而对照组均未恢复正常。结论胰岛素联合缬沙坦干预治疗可使部分早期糖尿病肾病患者尿蛋白排泄异常逆转,有助于疾病控制和治疗。
Objective To observe the effect of insulin combined with valsartan on early diabetic nephropathy. Methods Forty - six patients with early diabetic nephropathy were treated with insulin and valsartan (observation group) and 16 patients with conventional oral hypoglycemic drugs (control group). The fasting blood glucose, fasting plasma glucose Blood glucose, glycosylated hemoglobin, urinary albumin, creatinine, blood pressure, blood lipids and other levels. Results After 3 months of treatment, the fasting blood glucose was observed in the observation group. The blood glucose returned to normal at 2h after meal and the fluctuation of blood glucose was small. However, the blood glucose level of the control group decreased but fluctuated greatly. Urine microalbuminuria and urinary protein excretion rate The urinary albumin and urinary protein excretion rate began to decline in the observation group after 6 months of treatment. The urinary albumin and urinary protein excretion rate in the observation group after treatment for 1a was lower than that in the control group (P <0.01), of which 8 cases Urinary albumin up to normal levels, while the control group did not return to normal. Conclusion The combination of insulin and valsartan can reverse the abnormal urinary protein excretion in some patients with early diabetic nephropathy, which is helpful for disease control and treatment.