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[目的]观察贝那普利对2型糖尿病肾病病人血清抵抗素水平的影响及其临床意义。[方法]临床选择研究2型糖尿病病人89例,分为单纯糖尿病组(35例)、糖尿病肾病对照组(30例)和糖尿病肾病治疗组(24例)。所有患者均给予控制血糖药物常规治疗6个月,糖尿病肾病治疗组除控制血糖常规治疗外,还同时给予贝那普利片口服6个月(10mg/d)。各组治疗前后均测定空腹血糖(FPG)、糖化血红蛋白(HbA1c)、24h尿白蛋白定量(24hUA)和抵抗素水平。[结果]①治疗前糖尿病肾病对照组、糖尿病肾病治疗组分别与单纯糖尿病组对比,FPG、HbA1c无统计学差异(P﹥0.05),但24hUA和抵抗素水平均有明显升高,差异有统计学意义(P﹤0.05)。而糖尿病肾病对照组与糖尿病肾病治疗组对比,FPG、HbA1c、24hUA和抵抗素水平均无统计学差异(P﹥0.05)。②治疗6个月后糖尿病肾病对照组与单纯糖尿病组对比,两组的FPG、HbA1c均较治疗前明显下降,且两组治疗前后对比下降幅度无统计学差异(P﹥0.05);糖尿病肾病对照组治疗后抵抗素水平明显下降,但下降幅度高于单纯糖尿病组,差异有统计学意义(P﹤0.05);与治疗前对比,糖尿病肾病对照组治疗后24hUA也明显下降。③治疗6个月后糖尿病肾病治疗组与糖尿病对照组对比,两组的FPG、HbA1c均较治疗前明显下降,且两组治疗前后对比下降幅度无统计学差异(P﹥0.05);糖尿病肾病治疗组治疗后24hUA和抵抗素水平明显下降,且下降幅度高于糖尿病对照组,差异有统计学意义(P﹤0.05)。[结论]抵抗素可能在糖尿病肾病的发病中起着重要的作用,血管紧张素转换酶抑制剂通过降低抵抗素水平来改善糖尿病肾病。
[Objective] To observe the effect and clinical significance of benazepril on serum resistin in patients with type 2 diabetic nephropathy. [Methods] 89 cases of type 2 diabetes mellitus were selected clinically. The patients were divided into simple diabetic group (35 cases), diabetic nephropathy control group (30 cases) and diabetic nephropathy treatment group (24 cases). All patients were given routine treatment of glycemic control for 6 months. Diabetic nephropathy group was given oral administration of benazepril orally for 6 months (10mg / d) in addition to routine blood glucose control. Fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), 24h urinary albumin (24hUA) and resistin levels were measured before and after treatment in each group. [Results] ①The levels of FPG and HbA1c in diabetic nephropathy control group and diabetic nephropathy treated group were significantly higher than those in simple diabetic group (P> 0.05), but the levels of 24hUA and resistin were significantly increased Significance (P <0.05). However, there was no significant difference in the levels of FPG, HbA1c, 24hUA and resistin between diabetic nephropathy control group and diabetic nephropathy treatment group (P> 0.05). ②Compared with diabetic group, the FPG and HbA1c of diabetic nephropathy group after 6 months treatment were significantly lower than those before treatment, and there was no significant difference between the two groups (P> 0.05); diabetic nephropathy control group The levels of resistin in the treatment group were significantly lower than those in the simple diabetic group (P <0.05). Compared with those before treatment, the diabetic control group showed a significant decrease in 24hUA after treatment. ③Compared with diabetic control group, the FPG and HbA1c in diabetic nephropathy group and control group after 6 months of treatment were significantly lower than those before treatment, and there was no significant difference between before and after treatment in the two groups (P> 0.05); diabetic nephropathy The level of UA and resistin in group 24 h after treatment decreased significantly (P <0.05), and the decrease was higher than that in diabetic control group. [Conclusion] Resistin may play an important role in the pathogenesis of diabetic nephropathy. Angiotensin converting enzyme inhibitors improve diabetic nephropathy by decreasing the level of resistin.