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目的:观察螺内酯和缬沙坦联合应用对早期糖尿病肾病患者尿白蛋白排泄率(UAER)的影响。方法:选取早期糖尿病肾病患者60例,分为联合治疗组30例和缬沙坦组30例,两组控制血糖方法相同,缬沙坦组给予缬沙坦80mg,每日1次,联合治疗组加服螺内酯20mg,每日1次。均连续治疗4个月,比较治疗前后两组患者血浆白蛋白、尿素氮、肌酐、肌酐清除率及UAER的变化,观察药物不良反应。结果:治疗4个月后,两组UAER均显著降低(P<0.01),且与缬沙坦组[(86±10)μg/min]相比,联合治疗组UAER[(68±13)μg/min]降低更显著(P<0.01),其他指标差异无统计学意义(P>0.05),未观察到严重不良反应。结论:缬沙坦与小剂量螺内酯联合应用降低早期糖尿病肾病患者的UAER效果更显著,且使用安全。
Objective: To observe the effect of spironolactone and valsartan on urinary albumin excretion rate (UAER) in patients with early diabetic nephropathy. Methods: Sixty patients with early diabetic nephropathy were selected and divided into three groups: 30 in the combination group and 30 in the valsartan group. The two groups were given the same blood glucose control method. The valsartan group was given valsartan 80 mg once daily. Plus service spironolactone 20mg, 1 times daily. All the patients were continuously treated for 4 months. The changes of plasma albumin, urea nitrogen, creatinine, creatinine clearance and UAER were compared between the two groups before and after treatment to observe adverse drug reactions. RESULTS: After 4 months of treatment, the UAER in both groups was significantly lower (P <0.01) and the UAER [(68 ± 13) μg) in the combination group was significantly lower than that in the valsartan group [(86 ± 10) μg / min) / min] (P <0.01). There was no significant difference in other indexes (P> 0.05). No serious adverse reactions were observed. Conclusion: Combination of valsartan with low-dose spironolactone can reduce UAER in patients with early diabetic nephropathy more effectively and safely.