摘要
Abstract
Objective To evaluate the clinical efficacy of pioglitazone in the treatment of early diabetic nephropathy and observe its effect on urinary microalbumin.Methods Single-center,double-blind,clinical randomized controlled trials were used.A random number table was used to generate random number.184 II ~ III diabetic nephropathy patients from department of nephrology and endocrinology in the first affiliated hospital of Chengdu Medical College were randomly divided into pioglitazone group(n=92)and placebo group(n=92).Besidesthe basic treatment of hypoglycemic,pioglitazone group took pioglitazone 30mg orally,once a day,and were observed for 3 months.Besidesthe basic treatment of hypoglycemic,placebo control group took the same appearancedesigned comfort drugs as pioglitazone.The medication frequency and course of treatment were the same as pioglitazone group.Evaluation index of clinical efficacy was efficient.The levels of fasting blood glucose,2 hours postprandial blood glucose,glycosylated hemoglobin,serum creatinine,urinary albumin excretion rate,C-reactive protein,alanine aminotransferase(ALT),aspartate aminotransferase(AST)and other indicators were observed before treatment,1 and 3 months after treatment.Results When after 3 months,in the pioglitazone group,the compliance rate of microalbumin was 42.2% higher than that in the placebo group,the difference was statistically significant(P<0.05)When after 1 month,the levels of 2 hours postprandial blood glucose,serum creatinine and urinary albumin excretion rate in the pioglitazone group were significantly lower than those in the control group(P<0.05),and the difference was statistically significant(P<0.05).Besides all of the above,when after 3 months,fasting blood glucose and C-reactive protein levels also showed a significant reduction.There was no statistically significant difference between the placebo group and the baseline(P>0.05).When after 1 month,the levels of 2 hours postprandial blood glucose,serum creatinine and urinary albumin excretion in the pioglitazone group were significantly lower than those in the placebo group(P<0.05).When after 3 months,besides above,C-reactive protein was also significantly lower than that in the placebo group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions and liver functionbetween the two groups after3 months of treatment(P> 0.05).Conclusion Pioglitazone has good clinical effect on improving the microalbuminuria in early diabetic nephropathy,which is superior to the placebo group and the incidence of adverse events is low.关键词
吡格列酮/糖尿病肾病/临床疗效/尿微量白蛋白Key words
pioglitazone/diabetic nephropathy/clinical efficacy/urinary microalbumi分类
医药卫生
