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目的观察缬沙坦联合胰激肽原酶治疗早期糖尿病肾病(DN)的临床疗效。方法 90例早期DN患者随机分成3组,缬沙坦联合胰激肽原酶组、缬沙坦组及对照组各30例,观察6个月,比较治疗前后患者尿白蛋白排泄率(UAER)、尿β2-微球蛋白(β2-GM)、平均动脉压(MAP)、血清肌肝(Scr)及糖化血红蛋白(HbA1c)变化。结果治疗后缬沙坦联合胰激肽原酶组及缬沙坦组UAER及尿β2-MG较治疗前显著下降(P<0.01),且较对照组显著下降(P<0.01),缬沙坦联合胰激肽原酶组较缬沙坦组下降更为显著(P<0.01),3组治疗后MAP较治疗前均有明显下降(P<0.01),3组之间无统计学差异(P>0.05)。结论缬沙坦联合胰激肽原酶治疗早期DN疗效确切,可有效减轻糖尿病肾病患者白蛋白尿。
Objective To observe the clinical efficacy of valsartan and pancreatic kallikrein in the treatment of early diabetic nephropathy (DN). Methods Ninety patients with early DN were randomly divided into three groups: 30 patients in valsartan combined with kallidinogenase group, valsartan group and control group were observed for 6 months. Urinary albumin excretion rate (UAER) (Β2-GM), mean arterial pressure (MAP), serum creatinine (Scr) and hemoglobin A1c (HbA1c) were measured. Results After treatment, the levels of UAER and urinary β2-MG in valsartan combined with kallikrein and valsartan decreased significantly (P <0.01) and decreased significantly compared with those in control group (P <0.01) The combination of pancreatic kallikrein and valsartan decreased more significantly than that of valsartan (P <0.01). The MAP in three groups decreased significantly after treatment (P <0.01), and there was no significant difference between the three groups (P > 0.05). Conclusion Valsartan combined with pancreatic kallikrein treatment of early DN exact effect, can effectively reduce the albuminuria in patients with diabetic nephropathy.