| Background:Diabetic kidney disease(DKD)is one of the common microvascular complications of diabetes and the leading cause of end-stage renal disease.The early treatment of diabetic kidney disease is particularly important not only to prolong the life cycle of patients,but also to reduce the economic burden of the country.At present,some studies have pointed out that the microalbuminuria stage is the earliest diagnostic stage of diabetic nephropathy,which can be curbed or reversed by treatment[1].However,the early treatment of diabetes nephropathy is limited clinically.At present,it has been proved that enhanced external counterpulsation can improve urinary Microalbumin in patients with hypertension.However,there are few studies on the effect of enhanced external counterpulsation on microalbuminuria in patients with type 2 diabetic kidney disease.Objective:To investigate the effect of enhanced external counterpulsation on microalbuminuria in patients with type 2 diabetic kidney disease and its possible mechanism.Methods:Thirty patients with type 2 diabetic kidney disease diagnosed as microalbuminuria in our hospital from January 2021 to December 2022 were randomly divided into EECP group(n=15)and control group(n=15).Both groups continued the previous treatment,and the EECP group was treated with enhanced external counterpulsation for 45 minutes,5 times a week,a total of 35 times.Fasting blood glucose,glycosylated hemoglobin,serum cystatin C,urinary microalbuminuria/creatinine,urinary microalbuminuria,interleukin-6,hypersensitive C-reactive protein and uric acid were recorded before and after treatment in EECP group and control group.The effects of EECP on microalbuminuria in patients with type 2 diabetic nephropathy were evaluated.Results:1.In this study,there were 0 cases of detachment,0 cases of exclusion,and 2 cases of discontinuation in the EECP group;In the control group,1 case was lost,0 case was removed,and 0 case was discontinued.No significant difference was found in sex,age,height,weight,body mass index,systolic blood pressure,diastolic blood pressure,mean arterial pressure,course of diabetes,fasting blood glucose,glycosylated hemoglobin,triglyceride,total cholesterol,low density lipoprotein cholesterol,ALT,AST,interleukin-6,high sensitivity C-reactive protein,serum cystatin C,serum creatinine,urinary microalbumin,uric acid and previous medication in baseline.2.After treatment of EECP,the serum cystatin C of decreased from 0.93±0.26 mg/L to 0.70±0.15 mg/L,the urinary microalbumin/creatinine ratio decreased from 24.44±29.49 ng/mmol to 11.15±13.20 ng/mmol,and the urinary microalbumin decreased from 91.82±88.71mg/L to 27.52±23.5 mg/L,all of which were notly lower than those before treatment.There was no statistically significant difference in glomerular filtration rate before and after treatment in EECP group.No significant difference was found in serum cystatin C,urinary microalbumin/creatinine ratio,urinary microalbumin and glomerular filtration rate before and after cure in the control group.After treatment of EECP,fasting blood glucose decreased from 7.61±2.12 mmol/L to 5.79 ± 0.92 mmol/L,the glycosylated hemoglobin decreased from 7.28±1.00%to 6.63 ±0.75%,the uric acid decreased from 404.61 ± 93.08 umol/L to 359.62±76.98 umol/L,the hypersensitive C-reactive protein decreased from 1.49±0.31 mg/L to 1.24±0.23 mg/L,and the Interleukin-6 decreased from 13.92±4.12ng/L to 8.75±2.10ng/L,all of which were significantly lower than those before treatment.No significant difference was found in fasting blood glucose,glycosylated hemoglobin,uric acid,hypersensitive C-reactive protein,interleukin-6 and other indicators before and after treatment in the control group.Conclusion:On the basis of commonly used drug therapy,enhanced external counterpulsation can reduce renal damage in patients with type 2 diabetic kidney disease during microalbuminuria. |
PDF Full Text Request