抗幽门螺杆菌治疗对早期2型糖尿病肾病的影响
发布时间：2018-09-10 10:32
【摘要】：目的探讨抗幽门螺杆菌(Helicobacter pylori,H.pylori)治疗对早期2型糖尿病肾病(diabetic kidney disease,DKD)临床疗效的影响。方法本研究选取我院2013年01月至2013年12月住院及门诊治疗的138例符合Mogensen DKD III期诊断的患者,采用14C尿素呼气试验(14C-urea breath test,14C-UBT)进行H.pylori感染检测,经筛查其中H.pylori阳性者为80例。将此80例患者随机分为抗H.pylori组(n=40)和非抗H.pylori组(n=40),两组均进行糖尿病教育、指导合理运动、限制蛋白质饮食基础上给予降糖及护肾治疗3个月,保持血糖及血压在一定范围内,抗H.pylori组同时给予标准三联疗法,即口服兰索拉唑(15 mg/次,2次/天),阿莫西林(1.0 g/次,2次/天),克拉霉素(0.5 g/次,2次/天)治疗7天。对两组治疗3个月前后尿白蛋白肌酐比值水平(urinary albumin to creatine ratio,UACR)、C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子(tumor necrosis factor-α,TNF-α)、血浆内皮素(plasma endothelin-1,ET-1)、同型半胱氨酸(homocysteine,HCY)、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)数据进行记录,并于治疗3个月后复查14C-UBT,应用SPSS19.0软件进行统计分析,计量资料以均数±标准差表示,两组间计量资料比较采用独立样本t检验,组内治疗前后比较采用配对t检验,计数资料比较采用χ2检验,P0.05为差异有统计学意义。结果1、经筛查80/138(57.97%)例Mogensen DKDⅢ期患者合并H.pylori感染;2、80例H.pylori感染患者中最终完成全部研究者共75例,包括抗H.pylori治疗者39例及未抗H.pylori治疗者36例,两组患者在性别、年龄、糖尿病病程、体重指数(BMI)、治疗前血糖(FBG、2h PG、Hb A1c)、血压(SBP、DBP)、血脂(TG、TC)及血浆UACR、CRP、TNF-α、ET-1、HCY水平方面均无显著统计学差异(P0.05)。3、治疗3个月后抗H.pylori组的H.pylori清除率显著高于未抗H.pylori组(56.41%vs5.6%,P0.01)。4、治疗3个月后抗H.pylori组和未抗H.pylori组的血糖(FBG、2 h PG、Hb A1c)、血压(SBP、DBP)及血脂(TG、TC)水平与治疗前基线水平比较均无显著统计学差异(P0.05)。5、两组血浆UACR、CRP、TNF-α、ET-1、HCY水平均较治疗前显著下降(P0.01);抗H.pylori组治疗后血浆UACR、CRP、TNF-α、ET-1、HCY水平均显著低于未H.pylori组(P0.05)。结论抗H.pylori治疗可能有助于降低DKD患者血浆UACR、CRP、TNF-α、ET-1、HCY水平,对延缓2型糖尿病早期肾病发展起一定作用。
[Abstract]:Objective to investigate the effect of anti-Helicobacter pylori (Helicobacter pylori,H.pylori) therapy on early type 2 diabetic nephropathy (diabetic kidney disease,DKD). Methods from January 2013 to December 2013, 138 inpatients and outpatients who met the stage of Mogensen DKD III diagnosis in our hospital were tested for H.pylori infection by 14C urea breath test (14C-urea breath test,14C-UBT). Among them, 80 cases were positive for H.pylori. The 80 patients were randomly divided into anti H.pylori group (n = 40) and non anti H.pylori group (n = 40). The two groups were given diabetes education to guide reasonable exercise, to treat hypoglycemia and protect kidney for 3 months on the basis of limiting protein diet, and to keep blood sugar and blood pressure within a certain range. The anti H.pylori group was treated with standard triple therapy: lansoprazole (15 mg/ day), amoxicillin (1. 0 g / d) and clarithromycin (0. 5 g / d twice a day) for 7 days. Serum levels of urinary albumin creatinine (urinary albumin to creatine ratio,UACR), tumor necrosis factor (tumor necrosis factor- 伪 (TNF- 伪), plasma endothelin (plasma endothelin-1,ET-1), homocysteine (homocysteine,HCY), triglyceride (triglyceride,TG) and total cholesterol (total cholesterol,TC) were recorded before and after 3 months of treatment in both groups. After 3 months of treatment, 14C-UBTs were reexamined and analyzed by SPSS19.0 software. The measurement data were expressed as mean 卤standard deviation. The measurement data between the two groups were compared with independent sample t test, and matched t test was used before and after treatment. There was significant difference in counting data by 蠂 2 test (P 0.05). Results 1 after screening 80 / 138 (57.97%) Mogensen DKD stage 鈪，
本文编号：2234189
[Abstract]:Objective to investigate the effect of anti-Helicobacter pylori (Helicobacter pylori,H.pylori) therapy on early type 2 diabetic nephropathy (diabetic kidney disease,DKD). Methods from January 2013 to December 2013, 138 inpatients and outpatients who met the stage of Mogensen DKD III diagnosis in our hospital were tested for H.pylori infection by 14C urea breath test (14C-urea breath test,14C-UBT). Among them, 80 cases were positive for H.pylori. The 80 patients were randomly divided into anti H.pylori group (n = 40) and non anti H.pylori group (n = 40). The two groups were given diabetes education to guide reasonable exercise, to treat hypoglycemia and protect kidney for 3 months on the basis of limiting protein diet, and to keep blood sugar and blood pressure within a certain range. The anti H.pylori group was treated with standard triple therapy: lansoprazole (15 mg/ day), amoxicillin (1. 0 g / d) and clarithromycin (0. 5 g / d twice a day) for 7 days. Serum levels of urinary albumin creatinine (urinary albumin to creatine ratio,UACR), tumor necrosis factor (tumor necrosis factor- 伪 (TNF- 伪), plasma endothelin (plasma endothelin-1,ET-1), homocysteine (homocysteine,HCY), triglyceride (triglyceride,TG) and total cholesterol (total cholesterol,TC) were recorded before and after 3 months of treatment in both groups. After 3 months of treatment, 14C-UBTs were reexamined and analyzed by SPSS19.0 software. The measurement data were expressed as mean 卤standard deviation. The measurement data between the two groups were compared with independent sample t test, and matched t test was used before and after treatment. There was significant difference in counting data by 蠂 2 test (P 0.05). Results 1 after screening 80 / 138 (57.97%) Mogensen DKD stage 鈪，
本文编号：2234189
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