简介：　　 [摘要 ]目的 研究分析瑞格列奈治疗老年 2型糖尿病合并糖尿病肾病（Ⅲ期）的临床效果。方法 此次研究的对象是选取 2018年 7月～ 2019年 12月于我院就诊的年龄≥ 60岁的 2型糖尿病合并糖尿病肾病（Ⅲ期）患者 200例，将其临床资料进行回顾性分析，并随机分为两组，瑞格列奈组（ A组， 100例）和门冬胰岛素 30R组（ B组， 100例），疗程 3个月，以空腹血糖（ FPG） <7.0 mmol/L，餐后 2 h血糖（ 2 hPG） <10.0 mmol/L为治疗目标；将血糖 <3.9 mmol/L定义为低血糖事件。记录治疗前后两组 FPG、 2 hPG、糖化血红蛋白（ HbA1c）、尿微量清蛋白、肌酐（ Cr）水平，低血糖发生率及血生化指标的变化，比较两种方法在降糖效果及安全性方面的差异。结果 两组患者治疗 3个月后 FPG、 2 hPG及 HbA1c、 Cr水平均明显下降，与治疗前比较，差异有统计学意义（ P<0.05）； A组低血糖发生率明显低于 B组，差异有统计学意义（ P<0.05）。结论 瑞格列奈治疗年龄≥ 60岁的 2型糖尿病合并糖尿病肾病（Ⅲ期）患者，能有效控制血糖，降低低血糖发生率，且对肾功能无影响。轻、中度肾功能损害的老年患者应用瑞格列奈是安全、有效的。  　　 [关键词 ]瑞格列奈；糖尿病肾病；老年患者；临床效果  　 [Abstract] Objective To study and analyze the clinical effect of repaglinide in the treatment of elderly patients with type 2 diabetes mellitus complicated with diabetic nephropathy (stage III). Methods from July 2018 to December 2019, 200 patients with type 2 diabetes mellitus complicated with diabetic nephropathy (stage III) were selected and randomly divided into two groups: repaglinide group (group A, 100 cases) and insulin aspart 30R group (group B, 100 cases). The course of treatment was 3 months, with fasting blood glucose (FPG) < 7.0 The treatment target was 2 h postprandial blood glucose (2 HPG) < 10.0 mmol / L; the hypoglycemia event was defined as blood glucose < 3.9 mmol / L. The levels of FPG, 2 HPG, HbA1c, urinary microalbumin, creatinine (CR), incidence of hypoglycemia and changes of blood biochemical indexes were recorded before and after treatment. The hypoglycemic effect and safety of the two methods were compared. Results the levels of FPG, 2 HPG, HbA1c and Cr in the two groups were significantly decreased after 3 months of treatment (P < 0.05); the incidence of hypoglycemia in group A was significantly lower than that in group B (P < 0.05). Conclusion repaglinide can effectively control blood glucose, reduce the incidence of hypoglycemia, and has no effect on renal function in patients with type 2 diabetes mellitus complicated with diabetic nephropathy (stage III) over 60 years old. It is safe and effective to use repaglinide in elderly patients with mild or moderate renal impairment.