CAJ | 학술논문

吡格列酮治疗糖尿病早期肾病的疗效观察，分析其可能的作用机制。方法92例糖尿病早期肾病患者随机分成两组，对照组给予瑞格列奈治疗，治疗组给予瑞格列奈和吡格列酮（30 mg/d）治疗，共16周。比较两组处理前后空腹胰岛素(FINS)、胰岛素敏感指数(ISI)、糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2 h 血糖(2hBG)、C 反应蛋白（CRP）、甘油三脂(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、纤维蛋白原(Fib)、24 h尿白蛋白排泄率(UAER)、肝功能、肾功能的变化。结果治疗组较对照组治疗后FBG、HbA1c、FINS、CRP、TG、LDL-C、Fib水平明显降低差异有统计学意义（P<0.05），并显著降低2hBG和UAER（P<0.01），同时提高HDL-C水平和ISI差异有统计学意义（P<0.05）。结论吡格列酮能降低血糖，并具有调脂、改善胰岛素敏感性、降低CRP改善炎症反应、尿白蛋白排泄的作用。
필격렬동치료당뇨병조기신병적료효관찰，분석기가능적작용궤제。방법92례당뇨병조기신병환자수궤분성량조，대조조급여서격렬내치료，치료조급여서격렬내화필격렬동（30 mg/d）치료，공16주。비교량조처리전후공복이도소(FINS)、이도소민감지수(ISI)、당화혈홍단백(HbA1c)、공복혈당(FBG)、찬후2 h 혈당(2hBG)、C 반응단백（CRP）、감유삼지(TG)、저밀도지단백(LDL-C)、고밀도지단백(HDL-C)、섬유단백원(Fib)、24 h뇨백단백배설솔(UAER)、간공능、신공능적변화。결과치료조교대조조치료후FBG、HbA1c、FINS、CRP、TG、LDL-C、Fib수평명현강저차이유통계학의의（P<0.05），병현저강저2hBG화UAER（P<0.01），동시제고HDL-C수평화ISI차이유통계학의의（P<0.05）。결론필격렬동능강저혈당，병구유조지、개선이도소민감성、강저CRP개선염증반응、뇨백단백배설적작용。
Objective To explore the efficacy and mechanism of pioglitazone for the treatment of early diabetic nephropathy (DN). Methods 92 patients with DN were randomly divided into two groups. The control group was given repaglinide for treatment, the treatment group was given repaglinide and pioglitazone (30mg/d)for treatment, for 16 weeks. The fasting insulin(FINS), insulin sen-sitivity index (ISI), glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), 2 hours blood glucose (2hBG), C-reactive protein (CRP), TG, LDL-C, HDL-C, fibrinogen (Fib), 24 h urinary albumin excretion rate (UAER), liver and kidney function of two groups were compared before and after treatment. Results After the treatment, compared with the control group, the level of FBG, HbA1c, FINS, CRP, TG, LDL-C, Fib of the treatment group was obviously lower (P<0.05), the level of 2hBG and UAER was also significantly lower (P<0.01), while the level of HDL-C and ISI higher (P<0.05). Conclusion Pioglitazone can reduce the level of blood sugar, regu-late lipid, improve the sensitivity of insulin, decrease CRP, ameliorate inflammatory reaction and urinary albumin excretion.