加味芪黄饮对治疗早期糖尿病肾病胰岛素抵抗的影响观察.doc

［关键词］糖尿病肾病；动脉硬化；脉搏波传导速度；大动脉顺应性 ［ ］R692 ［ ］A ［ ］1672-4062 (2016) 12 (b) -0007-04 ［Abstract］ Objective To investigate the change and related factors of PWV (pulse wave velocity), Cl (large arterial compliance index) in the patients with diabetic nephropathy. Methods Select January 2016 to October 2016, According to urinary albumin excretion and the level of estimated glomerular filtration rate (eGFR ), 180 patients with diabetic nephropathy were divided into early diabetic nephropathy group ， clinical diabetic nephropathy group and end stage renal disease group ， and 144 healthy people were enrolled as control group. Scrum albumin, serum creatinine (Scr), blood urea nitrogen, blood lipids, urinary protein, 24-hour ambulatory blood pressure, PWV and Cl were determined. Results Compared with the control group, cases increased PWV and end-stage diabetic nephropathy group is higher than clinical diabetic nephropathy and early diabetic nephropathy group； Case group Cl reduced than the control group, and clinical diabetic nephropathy end-stage diabetic nephropathy group is lower than group and early diabetic nephropathy. PWV and serum albumin, serum creatinine, urinary albumin, mean arterial pressure during the day and night ； Cl and scrum albumin , scrum creatinine , total cholesterol, urine protein, daytime and nighttime is related to the mean arterial pressure. Conclusion With the progress of diabetic nephropathy, the degree of atherosclerosis increases； various risk factors work together to promote atherosclerosis. [Keywords] Diabetic nephropathy； Arteriosclerosis； Pulse wave velocity； Arterial compliance index ?3着人口老龄化的到来，以及生活方式的改变，糖尿病发病率在 逐年升高，中国糖尿病患者匕达10.8%，甚至在局部地区糖尿病的检 出率高达12.7%[1]。糖尿病常导致心、脑、肾重要脏器的并发症，对 患者的生活质量以及生存率有较大影响。肾脏作为糖尿病最常累及的 器官，据美国、日本及许多欧洲国家统计资料表明，糖尿病肾病己经 升为终末期肾脏病首位因素，而国内导致终末期肾脏病的病因中糖尿 病肾病所占比例亦逐年增加。PWV可以反映动脉壁硬度，C1是大动脉 顺应性指数，其数值下降提示大动脉弹性减退，PWV以及C1用于评价 动脉硬化程度已得到公认。该文就PWV、C1在2型糖尿病肾病患者中 的变化进行分析，并对其相关危险因素进行分析，旨在对糖尿病肾病 患者动脉硬化的发生进行较早的评估，现报道如下。 1资料与方 法 1.1 一般资料 选取