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目的探讨螺内酯联合缬沙坦对早期糖尿病肾病(DN)患者尿蛋白及肾功能的影响。方法 98例DN患者随机分为对照组(46例)和观察组(52例),对照组仅予以缬沙坦治疗,观察组予以螺内酯联合缬沙坦治疗,对比两组治疗后肾脏参数与尿蛋白变化情况。结果两组治疗后尿素氮(BUN)、尿肌酐(Cr)、血尿酸(UA)水平比较差异无统计学意义(P>0.05),观察组血胱胺酸蛋白酶抑制剂C(cystatin C)较对照组明显减少(P<0.05);观察组治疗后4 h尿蛋白定量、α1微球蛋白(α1-MG)和β2微球蛋白(β2-MG)与NUG水平明显优于对照组(P<0.05)。结论早期DN患者应用螺内酯联合缬沙坦治疗,能显著降低患者的尿蛋白水平和保护肾脏,深具临床推广价值。
Objective To investigate the effects of spironolactone combined with valsartan on urinary protein and renal function in patients with early diabetic nephropathy (DN). Methods Ninety-eight DN patients were randomly divided into control group (n = 46) and observation group (n = 52). The control group was treated with valsartan only. The observation group was treated with spironolactone plus valsartan. Protein changes. Results There was no significant difference in the levels of BUN, Cr and UA between the two groups (P> 0.05). The cystatin C in the observation group was significantly lower than that in the observation group The levels of urinary protein, α1 microglobulin (α1-MG), β2-microglobulin (N-microglobulin) and NUG in the observation group at 4 h were significantly better than those in the control group (P < 0.05). Conclusion Spironolactone combined with valsartan in patients with early stage DN can significantly reduce urinary protein levels and protect the kidneys of patients with deep clinical value.