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目的:探讨伊贝沙坦对早期糖尿病肾病(diabeticnephropathy,DN)的治疗效果。方法:48例DN患者随机分为2组,每组24例,治疗组在使用降糖药控制血糖的基础上,加用伊贝沙坦150mg/d治疗,对照组仅用降糖药治疗。两组治疗3、9、12、15个月时复查血压、空腹血糖、餐后2小时血糖、糖化血红蛋白、尿蛋白排泄率、血肌酐、血钾、血尿酸水平,分别与其治前比较。结果:治疗组治疗后3个月、9个月、12个月、15个月时尿蛋白排泄率分别为(40.2±10.1)μg/min、(32.2±9.2)μg/min、(34.1±4.3)μg/min、(30.1±5.3)μg/min,比治疗前(42.5±11.2)μg/min明显减少(P<0.05),而且均低于对照组水平(P<0.05),用药过程未见不良反应;对照组在3个月、9个月、12个月、15个月时尿蛋白排泄率分别为(54.3±11.6)μg/min、(58.2±10.9)μg/min、(66.1±9.2)μg/min、(80.1±12.6)μg/min,比治疗前(41.9±12.3)μg/min增加(P<0.05);两组的平均动脉压、血糖、血钾、血尿酸、血肌酐水平治疗前后无明显差异。结论:伊贝沙坦对DN患者具有减少尿蛋白和保护肾功能作用,不良反应较少。
Objective: To investigate the therapeutic effect of irbesartan on diabetic nephropathy (DN). Methods: 48 patients with DN were randomly divided into two groups (24 in each group). The treatment group was treated with irbesartan 150 mg / d on the basis of blood glucose control with hypoglycemic agents and the control group was treated with hypoglycemic agents only. Blood pressure, fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin, urinary protein excretion rate, serum creatinine, serum potassium and serum uric acid were compared between the two groups at 3, 9, 12 and 15 months after treatment. Results: The urinary protein excretion rates in the treatment group were (40.2 ± 10.1) μg / min, (32.2 ± 9.2) μg / min, (34.1 ± 4.3) ) (P <0.05), and were significantly lower than those of the control group (P <0.05), and no significant difference was observed between the two groups (54.3 ± 11.6) μg / min, (58.2 ± 10.9) μg / min, (66.1 ± 9.2) g / min respectively in the control group at 3, 9, 12 and 15 months (P <0.05). The mean arterial blood pressure, blood glucose, serum potassium, serum uric acid, serum creatinine in the two groups were significantly higher than those before treatment (41.9 ± 12.3) μg / No significant difference between before and after treatment. Conclusion: Irbesartan can reduce urinary protein and protect renal function in patients with DN with less adverse reactions.