论文部分内容阅读
目的 :探讨胃旁路术对糖尿病肾病(diabetic nephropathy,DN)的疗效。方法 :回顾性分析58例接受胃旁路术的肥胖合并DNⅢ/Ⅳ期病人,随访1年分析手术对2型糖尿病、血压、肾功能以及蛋白尿的影响。结果:术后1年降糖及降压药物用量显著减少,体重、血糖、糖化血红蛋白以及胰岛素抵抗指标均显著下降,DNⅢ期和Ⅳ期糖尿病缓解率分别为83.9%和77.8%。手术前、后肾功能无显著变化,24 h尿蛋白(正常值为<30 mg/24 h)各组均有下降,DNⅢ期于术后1年恢复至正常水平[(78.68±58.48)mg/24 h比(17.67±14.45)mg/24 h,P<0.001],DNⅣ期组较术前持续降低[(1 143.51±969.68)mg/24 h比(493.57±725.72)mg/24 h,P>0.05]。结论:胃旁路术对2型糖尿病合并肥胖有显著减重、降糖的疗效,且有缓解DN进展的可能。
Objective: To investigate the effect of gastric bypass on diabetic nephropathy (DN). Methods: A retrospective analysis of 58 obese patients with gastric bypass who underwent DN Ⅲ / Ⅳ was performed. The follow-up of 1 year was performed to analyze the effect of surgery on type 2 diabetes mellitus, blood pressure, renal function and proteinuria. Results: The dosage of hypoglycemic drugs and antihypertensive drugs decreased significantly at 1 year after operation. The body weight, blood glucose, glycosylated hemoglobin and insulin resistance index decreased significantly. The response rates of DN stage Ⅲ and Ⅳ diabetes were 83.9% and 77.8% respectively. There was no significant change in renal function before and after surgery. The levels of 24 h urine protein (normal <30 mg / 24 h) decreased in each group, and returned to normal level at 1 year after DN stage [(78.68 ± 58.48) mg / (1 143.51 ± 969.68) mg / 24 h (493.57 ± 725.72) mg / 24 h, P> 0.05]. Conclusion: Gastric bypass has a significant effect on weight loss and hypoglycemic effect of type 2 diabetes mellitus with obesity, and may alleviate the progression of DN.