本文選題：二甲雙胍　切入點：2型糖尿病　出處：《安徽醫(yī)科大學》2016年碩士論文

【摘要】：目的觀察二甲雙胍(Metformin,Met)對2型糖尿病(type 2 diabetesmellitus,T2DM)患者腫瘤壞死因子(tumor necrosis factor,TNF)-α、單核細胞趨化蛋白(monocyte chemoattractant protein,MCP)-1及C反應蛋白(C-reactive protein, CRP)等尿炎癥因子排泄的影響,探討其可能存在的腎臟保護作用。方法121例2型糖尿病(type 2 diabetes mellitus, T2DM)患者(DM組)根據(jù)抗糖尿病治療方案分為胰島素(insulin, INS)組(N=60)和磺脲類(sulfonylurea,SU)組,再依據(jù)是否聯(lián)合Met各分兩個亞組(INS-Ⅰ組：單一INS治療；INS-Ⅱ組：INS聯(lián)合Met；SU-Ⅰ組：單一SU治療；SU-Ⅱ組：SU聯(lián)合Met治療),同期,選取我院體檢中心24名健康體檢人員作為正常對照組(normal control, NC組),比較各組之間年齡、體重指數(shù)(body mass index, BMI)、血壓和血肌酐(creatinine,SCr)、空腹血糖(fasting blood glucose, FBG)、餐后2小時后血糖(postprandial blood glucose, PBG)、糖化血紅蛋白(glycated haemoglobinA1c, HbA1c)、尿白蛋白肌酐比(Urinary albumin/creatinine ratio, UACR)、尿TNF-α肌酐比(urinary TNF-α/creatinineratio, UTCR)、尿MCP-1肌酐比(urinary MCP-1/creatinineratio, UMCR)、尿CRP肌酐比(urinary CRP/creatinineratio,UCCR)等指標的變化。結果1、DM組與NC組比較1.1 DM組與NC組組間年齡、BMI、血壓和血SCr差異無統(tǒng)計學意義(P0.05)。1.2與NC組比較,DM組FBG、PBG和HbA1c顯著升高,差異有統(tǒng)計學意義,P0.05,分別為(7.21±0.14 VS 4.85±0.10) mmol/L, (9.71±0.31 VS 5.24±0.22) mmol/L, (7.03±0.10 VS 5.22±0.06)%。1.3與NC組比較,DM組UACR、UTCR、UMCR和UCCR顯著升高,差異均有統(tǒng)計學意義,P0.05,分別為(27.68±3.99 VS 13.63±1.03) mg/gCr,(152±34.43 VS 60.23±12.27) pg/ngCr, (95.96±17.10 VS 30.71±1.83) pg/ngCr, (6.89±1.25 VS 2.14±0.89) pg/mgCr。2、INS-Ⅱ組與INS-Ⅰ組比較2.1 INS-Ⅱ組與INS-Ⅰ組間年齡、病程、BMI、血壓、血SCr、FBG、PBG和HbA1c差異無統(tǒng)計學意義(P0.05)。2.2與INS-Ⅰ組比較,INS-Ⅱ組UACR、UTCR, UMCR和UCCR明顯降低,差異有統(tǒng)計學意義,P0.05,分別為(10.48±1.98 VS 42.96±6.24) mg/gCr, (51.12±9.56VS 166.9±44.04)pg/ngCr, (27.42±4.45 VS 116.2±10.47)pg/ngCr, (2.83±0.43VS10.04±2.96) pg/mgCr。3、SU-Ⅱ組與SU-Ⅰ組比較3.1 SU-Ⅱ組與SU-Ⅰ組間年齡、病程、BMI、血壓、血SCr、FBG、PBG和HbA1c差異無統(tǒng)計學意義(P0.05)。3.2與SU-Ⅰ組比較,SU-Ⅱ組UACR, UTCR, UMCR和UCCR明顯降低,差異有統(tǒng)計學意,P0.05,分別為(18.31±5.70 VS 52.43±7.80) mg/gCr, (62.14±7.38 VS110.4±14.27) pg/ngCr, (53.58±8.11 VS 240.8±12.77) pg/ngCr, (3.11±0.68 VS11.26±3.18) pg/mgCr。4、T2DM患者UTCR、UMCR、UCCR分別與UACR呈顯著性正相關(r=0.73,P0.01；r=0.79,P0.01；r=0.53,P0.01；)。分別以UTCR、UMCR、UCCR作為應變量,以其他因素作為自變量,進行多元線性逐步回歸分析,結果顯示UACR分別是UTCR、UMCR、UCCR的獨立相關因素。結論1、糖尿病患者體內存在低度增強的炎癥反應并與糖尿病腎損害有關。2、聯(lián)合應用Met可降低T2DM患者尿炎癥因子的排泄,該作用可能與其腎臟保護有關。
[Abstract]:Objective to observe the effect of metformin metformin on the excretion of inflammatory cytokines such as tumor necrosis factor- 偽, monocyte chemoattractant protein MCP-1and C-reactive protein (CRP-) in patients with type 2 diabetes mellitus type 2 diabetes mellitus (type 2 diabetes mellitus). Methods 121 patients with type 2 diabetes mellitus (type 2 diabetes mellitus, T2DM) were divided into two groups according to the antidiabetic regimen: insulin (ins) group (n = 60) and sulfonylurea suis group (n = 121). According to whether or not combined with Met, each group was divided into two subgroups: single INS group: single INS group: 1% ins combined with Metsu- 鈪，

本文編號：1679871