二甲双胍联合骨化三醇对2型糖尿病患者肾功能及视网膜的保护作用
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篇名: 二甲双胍联合骨化三醇对2型糖尿病患者肾功能及视网膜的保护作用
TITLE:
摘要: 目的:探讨二甲双胍联合骨化三醇对2型糖尿病患者肾功能及视网膜的保护作用。方法: 80例2型糖尿病伴早期糖尿病肾病、轻中度非增生期视网膜病变患者采用随机数字表法分为对照组(40例)和观察组(40例)。对照组患者给予盐酸二甲双胍片,起始剂量为0.5 g/次,随餐服用(2次/d),每周增加0.5 g,逐渐增加至2 g/d。观察组患者在对照组治疗的基础上加用骨化三醇胶丸0.25 μg/次,1次/d。两组均持续治疗并随访6个月。观察两组患者临床疗效,治疗前后血糖水平[2 h餐后血糖(2 h PG)、空腹血糖(FPG)]、肾功能指标[尿白蛋白与肌酐比值(ACR)、尿白蛋白排泄率(UAER)、尿蛋白定量(Pr)]与视力和视野缺损、眼底血管造影情况及不良反应发生情况。结果:观察组患者总有效率显著高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者2 h PG、FPG、ACR、UAER、Pr与视力和视野缺损、眼底血管造影情况比较,差异均无统计学意义(P>0.05)。治疗后,两组患者2 h PG、FPG、ACR、Pr、UAER、视野缺损平均值、眼底微血管数和出血面积均显著低于同组治疗前,且观察组低于对照组;视力显著高于同组治疗前,且观察组高于对照组,差异均有统计学意义(P<0.05)。两组患者治疗期间各有1例轻微不良反应。结论:二甲双胍联合骨化三醇对2型糖尿病患者肾功能及视网膜具有一定保护作用,能降低患者2 h PG、FPG、ACR、Pr、UAER、视野缺损平均值、眼底微血管数和出血面积,升高视力,且临床不良反应较小,安全性较高。
ABSTRACT: OBJECTIVE: To observe the protection effects of Metformin combined with Calcitriol on renal functiou and retina in patients with type 2 diabetes. METHODS: 80 patients with type 2 diabetes with early diabetic nephropathy and mild-to-moderate non proliferative retinopathy were randomly divided into control group (40 cases) and observation group (40 cases). Control group received Metformin hydrochloride tablet with initial dose of 0.5 g, twice a day during a meal, increased 0.5 g every week, then gradually increased to 2 g every day; observation group additionally received Calcitriol soft capsule, 0.25 μg/times, once a day. The treatment lasted and followed-up for 6 months. Efficacy of retinopathy, blood glucose levels [2 h postprandial blood glucose (2 h PG), blood glucose (FPG)], renal function indexes [urinary albumin-to-creatinine ratio (ACR), urinary albumin excretion rate (UAER), proteinuria (Pr)], vision and visual field defects, fundus angiography before and after treatment, and the incidence of adverse reactions in 2 groups were observed. RESULTS: The total effective rate in observation group was significantly higher than in control group, and the difference was statistically significant (P<0.05). Before treatment, there were no significant differences in the 2 h PG, FPG, ACR, UAER, Pr, vision and visual field defects between 2 groups (P>0.05). After treatment, 2 h PG, FPG were significantly lower than before;ACR, Pr, UAER, average value of visual field defects, fundus angiography and bleeding area were significantly lower than before, and observation group was lower than control group; vision was significantly higher than before, and observation group was higher than control group. The differences were statistically significant (P<0.05). There was respectively 1 patient showed slight adverse reactions in both groups. CONCLUSIONS: Metformin combined with Calcitriol has certain protection effect on the renal function and retina in patients with type 2 diabetes, it can reduce 2 h PG, FPG, ACR, Pr, UAER, average value of visual field defects, fundus angiography and bleeding area of patients and improve vision, with small adverse reactions and high safety.
期刊: 2016年第27卷第30期
作者: 王文菊,孔云龙
AUTHORS: WANG Wenju,KONG Yunlong
关键字: 二甲双胍;骨化三醇;糖尿病肾病;视网膜病变
KEYWORDS: Metformin; Calcitriol; Diabetic nephropathy; Retinopathy
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