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目的:观察羟苯磺酸钙联合阿魏酸哌嗪治疗早期糖尿病肾病(DN)的疗效并探讨其作用机制。方法:将我科收治的85例早期DN患者随机分为治疗组和对照组,对照组常规降糖治疗,治疗组常规降糖加用羟苯磺酸钙片500 mg,1 d 3次,阿魏酸哌嗪片200 mg,1日3次,疗程6个月。观察治疗前后尿白蛋白排出量(UAE)、空腹血糖(FBG)、餐后2 h血糖(PBG)、糖化血红蛋白(HbA1C)、肝肾功能、凝血功能、血脂、血栓烷素B2(TXB2)及高敏C反应蛋白(hs-CRP)变化。结果:治疗后3个月,治疗组UAE开始下降(P<0.05),对照组无明显下降(P>0.05);治疗后6个月,治疗组纤维蛋白原(FIB)、低密度脂蛋白胆固醇(LDL-C)、TXB2、hs-CRP均明显下降(P<0.01),FBG、PBG、HbA1C、肝肾功能差异无统计学意义;对照组治疗前后各项指标无明显改变(P>0.05)。结论:羟苯磺酸钙联合阿魏酸哌嗪能减轻早期DN尿白蛋白排泄,部分逆转DN进展,其通过降低FIB、LDL-C、TXB2、hs-CRP等改善高凝、微炎症状而实现肾脏保护作用。
Objective: To observe the efficacy of calcium dobesilate combined with piperazine ferulate in the treatment of early diabetic nephropathy (DN) and to explore its mechanism. Methods: Eighty-five patients with early-stage DN treated in our department were randomly divided into treatment group and control group. The control group was given conventional hypoglycemic treatment. The treatment group was given conventional hypoglycemic treatment with calcium dobesilate 500 mg once a day for three times Piperazine hydrochloride tablets 200 mg, 3 times a day, treatment for 6 months. Urinary albumin excretion (UAE), fasting blood glucose (FBG), postprandial blood glucose (PBG), HbA1C, liver and kidney function, blood coagulation, blood lipid, TXB2 and High sensitive C-reactive protein (hs-CRP) changes. Results: At 3 months after treatment, UAE began to decrease (P <0.05) in treatment group and no significant decrease in control group (P> 0.05). At 6 months after treatment, fibrinogen (FIB), low density lipoprotein cholesterol (P <0.01), FBG, PBG and HbA1C had no significant difference between the two groups (P> 0.05) . CONCLUSION: Calcium dobesilate combined with ferulic acid piperazine can relieve the excretion of early DN urinary albumin and partially reverse the progression of DN. It can improve hypercoagulability and micro-inflammation by reducing FIB, LDL-C, TXB2 and hs-CRP Realize kidney protection.