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目的观察血管紧张素转换酶抑制剂联合他汀类降脂药治疗糖尿病肾病的临床疗效。方法糖尿病肾病Ⅳ期患者84例,随机分为对照组(福辛普利钠治疗)和治疗组(辛伐他汀+福辛普利钠治疗)。治疗12周后测定24 h尿蛋白定量(UAE)、血肌酐(Cr)、血尿素氮(BUN)、血尿酸(UA)、空腹血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)、血清胱抑素(Cystatin C)。结果①治疗组及对照组患者治疗前组间比较:两组患者上述指标比较差异无统计学意义。②治疗组与对照组治疗前后比较:两组患者24 h-UAE、Cystatin C治疗后均较治疗前降低(P<0.05);治疗组患者TG、TC、LDL较治疗前减低,HDL较治疗前升高;治疗组及对照组患者治疗前后FBG、Cr、BUN、UA均无明显变化。③治疗组及对照组治疗后组间比较:治疗组患者24 h-UAE、Cystatin C、TG、TC、LDL均较对照组低,HDL较对照组高;而治疗后两组患者FBG、Cr、BUN、UA均无明显变化。结论他汀类降脂药联合血管紧张素转换酶抑制剂可通过有效改善早期糖尿病肾病而达到延缓肾功能衰竭进展的目的。
Objective To observe the clinical efficacy of angiotensin converting enzyme inhibitor combined with statins lipid-lowering drugs in the treatment of diabetic nephropathy. Methods Eighty-four patients with stage Ⅳ diabetic nephropathy were randomly divided into control group (fosinopril sodium treatment) and treatment group (simvastatin + fosinopril sodium treatment). After 12 weeks of treatment, 24 h urinary protein (UAE), serum creatinine (Cr), blood urea nitrogen (BUN), serum uric acid (UA), fasting blood glucose (FBG), triglyceride (TG), total cholesterol ), High-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), and serum cystatin C. Results ① The treatment group and control group patients before treatment comparison: the two groups of patients with no significant difference in the above indicators. ②The levels of TG, TC and LDL in treatment group and control group before and after treatment were lower than those before treatment in 24 h-UAE and Cystatin C treatment groups (P <0.05) Increased; the treatment group and control group patients before and after treatment FBG, Cr, BUN, UA no significant change. The treatment group and the control group after treatment group comparison: the treatment group 24 h-UAE, Cystatin C, TG, TC, LDL were lower than the control group, HDL higher than the control group; after treatment, the two groups of patients FBG Cr, BUN, UA no significant change. Conclusion Statins lipid-lowering drugs combined with angiotensin-converting enzyme inhibitors can achieve the purpose of retarding the progression of renal failure by effectively improving early diabetic nephropathy.