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目的比较甘精胰岛素和精蛋白锌胰岛素作为基础胰岛素治疗在合并糖尿病肾病的糖尿病患者中疗效。方法将67名合并糖尿病肾病的患者随机分为两组,分别给予甘精胰岛素/精蛋白锌胰岛素加阿卡波糖治疗,餐后空腹血糖达标后观察12周,比较两组患者HbAlc达标率、达标后胰岛素用量,达标后心绞痛发生率(含发生心肌梗塞)。结果甘精胰岛素治疗组HbAlc达标率与精蛋白锌胰岛素组无显著差异,但达标后胰岛素用量甘精胰岛素治疗组胰岛素剂量小于精蛋白锌胰岛素组,而且达标时间也短于精蛋白锌胰岛素组,低血糖发生率也显著低于精蛋白锌胰岛素组,心绞痛发生率也低于精蛋白锌胰岛素组。结论甘精胰岛素可通过减少低血糖发生率、减少胰岛素剂量、缩短达标时间减低合并糖尿病肾病的糖尿病患者心绞痛发生率。
Objective To compare the effects of insulin glargine and protamine zinc insulin as basic insulin therapy in diabetic patients with diabetic nephropathy. Methods Sixty-seven patients with diabetic nephropathy were randomly divided into two groups, treated with insulin glargine / protamine and insulin plus acarbose respectively. After fasting plasma glucose was observed for 12 weeks, the compliance rates of HbA1c, After the standard insulin dosage, angina pectoris (including the occurrence of myocardial infarction). Results The compliance rate of HbA1c in glargine treatment group was not significantly different from that of protamine zinc insulin group, but the insulin dosage of insulin glargine treatment group was less than that of protamine zinc insulin group after reaching the standard, and the compliance time was shorter than that of protamine zinc insulin group. The incidence of hypoglycemia was also significantly lower than that of the protamine zinc insulin group, and the incidence of angina pectoris was also lower than that of the protamine zinc insulin group. Conclusion Glargine can reduce the incidence of angina in diabetic patients with diabetic nephropathy by reducing the incidence of hypoglycemia, decreasing the dosage of insulin and shortening the target time.