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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 |
| 阅读数： | 793 次 |
| 本月下载数： | 2 次 |
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