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目的：探讨胰岛素强化治疗对Ⅱ型DM肾病(DN)的治疗效果。方法：分别对18例DNⅢ期和23例DNⅣ期患者进行强化治疗2~3个月，治疗前后监测血糖、糖化血红蛋白、尿蛋白和尿微量白蛋白的变化。结果：所有DN患者血糖、HbAic、24 h尿微量白蛋白、24 h尿总蛋白降低(P＜0．01)。蛋白尿阴转率在DNⅢ期为56．7％，DNⅣ期为30．10％。DNⅢ期阴转率大于Ⅳ期，而24 h尿总蛋白大于1 000 mg以上的4例DNⅣ期患者，其尿蛋白降低不明显。结论：胰岛素强化治疗能防止DN的发展，对早期肾病的治疗效果优于临床期。
Objective: To investigate the therapeutic effect of intensive insulin therapy on type Ⅱ DM nephropathy (DN). Methods: Eighteen patients with DN stage Ⅲ and 23 patients with stage Ⅳ DN were intensively treated for 2 to 3 months. The changes of blood glucose, glycosylated hemoglobin, urine protein and urinary albumin before and after treatment were monitored. Results: The blood glucose, HbAic, 24 h urine microalbumin and 24 h urinary total protein in all DN patients decreased (P <0.01). The proteinuria negative conversion rate was 56.7% in DNIII and 30.10% in DNⅣ. In DN stage Ⅲ, the negative conversion rate was higher than that in stage Ⅳ, while in 4 cases of stage ⅣⅣ patients whose urine total protein was more than 1 000 mg at 24 hours, the urinary protein loss was not obvious. Conclusion: Intensive insulin therapy can prevent the development of DN, the treatment of early renal disease better than the clinical stage.