【摘要】 目的 观察二甲双胍对T2DM早期糖尿病肾病(DN)的疗效。方法 将118例T2DM并发早期DN的患者随机分为二甲双胍组和阿卡波糖组。两组分别在服用二甲双胍及阿卡波糖的基础上口服贝那普利片20 mg/d，疗程24周。观察两组治疗前后的BP、血糖、HbA1c、稳态模型IR指数(HOMA-IR)、高敏C反应蛋白(hsC-RP)、尿白蛋白排泄率(UAER)的变化。 结果 二甲双胍组治疗前后的血压、血糖、HbA1c、HOMA-IR、hsC-RP、UAER的变化明显，差异有统计学意义。UAER治疗前(106.1±20.45)μg/min, 治疗后(52.12±10.34)μg/min，(P<0.05);阿卡波糖组BP、hsC-RP、UAER治疗前后变化差异无统计学意义 (P>0.05)。结论 对于T2DM早期DN的患者，二甲双胍即在降糖的同时，又能降低UAER。

　　【关键词】 二甲双胍;糖尿病，2型;糖尿病肾病;尿白蛋白排泄率

　　Therapeutic effects of metformin on early diabetic nephropathy in T2DM patients XIAO Xue-na, WANG Ying, MA Cai-juan, et al. Department of Endocrinology, Tangshan the Third Hospital, Tangshan 063100, China

　　【Abstract】Objective To observe the therapeutic effects of metformin on early diabetic nephropathy in T2DM patients. Methods The 118 T2DM patients with early diabetic nephropathy were randomized into two groups, metformin group and acarbose group. Both groups were administered benazepril 20mg/d at the same time in addition to metformin and acarbose respectively. The course of treatment was of 24 weeks. The changes in parameters including blood pressure (BP), plasma glucose (PG), HbA1c, HOMA-IR, high sensitivity C-reaction protein (hs C-RP), and urinary albumin excretory rate (UAER) were observed after treatment. Results In the metformin group, the changes in BP, PG, HbA1c, HOMA-IR, hsC-RP, and UAER after treatment showed significant difference (P<0.05), and the UAER changed from 106.1±20.45 μg/min to 52.12±10.34 μg/min (P<0.05). In the acarbose group, there were no significant changes in BP, HOMA-IR, hsC-RP, UAER after treatment (P>0.05). Conclusion For the T2DM patients with early diabetic nephropathy, metformin can lower plasma glucose and reduce UAER.

　　【key words】 Metformin; Diabetes mellitus, type 2; Diabetic nephropathy; Urinary albumin excretory rate