本文選題：2型糖尿病 + 早期糖尿病腎病��； 參考：《新疆醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的：探討關(guān)于GLP-1受體激動劑艾塞那肽對糖尿病腎病(Diabetic nephropathy,DN)合并肥胖患者的臨床療效。方法：選取2012年9月至2013年12月在新疆醫(yī)科大學(xué)內(nèi)分泌科診斷為2型糖尿病(type 2 diabetes mellitus,T2DM)合并糖尿病腎病的患者,根據(jù)納入標準及排除標準最終入組80例,按治療方案的不同,分為普通中效胰島素+二甲雙胍組(對照組)及普通中效胰島素+二甲雙胍組+艾塞那肽組(艾塞那肽組)。收集兩組年齡、病程、腹圍、身體質(zhì)量指數(shù)(body mass index,BMI)、糖化血紅蛋白(glycosylated hemoglobin,HbAlc)、空腹血糖(fasting blood-glucose,FPG),餐后2小時血糖(2-hour postprandial blood glucose,2h-PG)、尿微量白蛋白(microalbumin,mALb)、收縮壓(systemic blood pressure,SBP)、舒張壓(diastolic blood pressure,DBP)、高敏C反應(yīng)蛋白(high seneitivity-C-reactive protein,hs-CRP)、同型半胱氨酸(homocysteine,Hcy)、尿肌酐(urine creatinine,Ucr)等基線數(shù)據(jù),隨訪16周后對比兩組上述各項指標。結(jié)果：(1)治療后兩組FPG、2-PG、HbAIc均較治療前明顯降低(均P0.05)；對照組與艾塞那肽組對FPG的控制無顯著性差異(P0.05),而兩組治療后2h-PG及HbAIc差異有統(tǒng)計學(xué)意義(P0.05)。(2)治療16周后,艾塞那肽組腹圍及BMI均較治療前有明顯降低,差異有統(tǒng)計學(xué)意義(均P0.05)；對照組腹圍及BM[無明顯改變,差異無統(tǒng)計學(xué)意義(均P0.05)。(3)艾塞那肽組SBP較治療前顯著下降,差異有統(tǒng)計學(xué)意義(P0.05), DBP治療前后無明顯改變,差異無統(tǒng)計學(xué)意義(均P0.05)；對照組SBP及DBP治療前后均無明顯改變,差異無統(tǒng)計學(xué)意義(均P0.05)。(4)艾塞那肽組經(jīng)16周治療后hs-CRP、Hcy均較治療前顯著下降,差異有統(tǒng)計學(xué)意義(均P0.05)；(5)艾塞那肽組與對照組mALb、ACR均較治療前顯著下降,差異有統(tǒng)計學(xué)意義(均P0.05)；結(jié)論：艾塞那肽在控制糖尿病患者血糖同時可以有效減輕體重、減少尿蛋白、抑制炎癥反應(yīng)及氧化應(yīng)激,從而可以起到延緩DN患者腎功進展的降糖外效應(yīng)。
[Abstract]:Objective: to investigate the clinical effect of Isenapeptide, a GLP-1 receptor agonist, on diabetic nephropathytic DNs complicated with obesity. Methods: from September 2012 to December 2013, 80 patients with type 2 diabetes mellitus type 2 diabetes mellitusus T2DMwere diagnosed in the Department of Endocrinology, Xinjiang Medical University. They were divided into two groups: normal medium effect insulin metformin group (control group) and general medium effect insulin metformin group (Isenapeptide group). Two groups of age, course of disease, abdominal circumference were collected. Body mass index (mass), glycosylated hemoglobinine (glycosylated hemoglobin), glycosylated hemoglobinine (HbAlcN), fasting blood glucose (fasting), blood glucose (glucose), 2-hour postprandial blood glucose (2h-PGN), urinary microalbumin (Alb), systolic blood pressure (SBP), diastolic blood pressure (DBP), Gao Min C-reactive protein high seneitivity-C-reactive protein (hs-CRPN), homocysteine (HCH), homocysteine (HCT). Baseline data such as urine creatinine After 16 weeks follow-up, the above indexes were compared between the two groups. Results [WT5 "HZ] after treatment, the levels of FPG in the two groups were significantly lower than those before treatment (P 0.05, P 0.05), but there was no significant difference in the control of FPG between the control group and the Eisenapeptide group (P 0.05), but there was a statistically significant difference in 2 h-PG and HbAIc between the two groups at 16 weeks after treatment. The abdominal circumference and BMI of the Isenapeptide group were significantly lower than those of the control group (P 0.05), the abdominal circumference and BM of the control group were not changed, and the difference was not statistically significant (P0.05. 0. 0. 3) the SBP of the Isenapeptide group was significantly lower than that of the control group (P 0. 05, P < 0. 05, P < 0. 05). The difference was statistically significant (P 0.05), but there was no significant change in DBP before and after treatment (all P 0.05), but there was no significant change in SBP and DBP in control group before and after treatment. After 16 weeks of treatment, hs-CRP Hcy was significantly lower in the Isenapeptide group than in the pre-treatment group (P 0.05, P 0.05). The ACR of mALbn in the Eisenapeptide group and the control group was significantly lower than that in the control group after 16 weeks of treatment. Conclusion: Isenapeptide can effectively reduce body weight, reduce urinary protein, inhibit inflammatory reaction and oxidative stress in diabetic patients. Thus, it can delay the progression of renal function in DN patients.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R587.1;R589.2
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本文編號：2048574