论文部分内容阅读
目的观察氯沙坦联合α-酮酸治疗早期糖尿病肾病的临床疗效及对血压、血糖、肾功及营养代谢指标的影响。方法选择广东省阳江市中西医结合医院2012年1月-2014年9月收治的2型糖尿病肾病患者64例作为研究对象,按随机数字表分为观察组32例和对照组32例,两组患者均常规给予降压药物(β受体阻滞剂或利尿剂)、胰岛素及低蛋白饮食,对照组给予氯沙坦治疗50 mg/次、1次/d;观察组给予氯沙坦联合α-酮酸,氯沙坦50 mg/次、1次/d,α-酮酸2.4 g/次、3次/d。两组患者均治疗12周,治疗前后检测两组患者血压及血糖指标,肾功能、代谢相关指标。结果观察组治疗后糖化血红蛋白、收缩压、24 h尿清蛋白量、尿蛋白排泄率(UAER)较治疗前明显降低(均P<0.05),且观察组上述指标明显低于对照组(均P<0.05)。观察组治疗后白蛋白、血红蛋白明显高于对照组(P<0.05)。结论氯沙坦联合α-酮酸是早期糖尿病肾病的有效方法,能够有助于稳定血压,减少尿蛋白,延缓肾脏功能损伤,且可改善患者营养状况,有利于糖尿病肾病进展控制。
Objective To observe the clinical efficacy of losartan combined with α-keto acid in the treatment of early diabetic nephropathy and its effects on blood pressure, blood glucose, renal function and nutritional metabolism. Methods 64 cases of type 2 diabetic nephropathy admitted from January 2012 to September 2014 in Yangjiang Integrative Hospital of Guangdong Province were divided into observation group (32 cases) and control group (32 cases) according to random number table. Two groups Patients were given routine antihypertensive drugs (β blockers or diuretics), insulin and low protein diet, the control group given losartan 50 mg / time, 1 / d; the observation group given losartan combined with α - keto acid, losartan 50 mg / time, 1 time / d, α-keto acid 2.4 g / time, 3 times / d. Two groups of patients were treated for 12 weeks, before and after treatment to detect blood pressure and blood glucose in two groups of indicators, renal function, metabolism-related indicators. Results After treatment, the levels of HbA1c, systolic pressure, 24-hour urinary albumin and urinary protein excretion (UAER) in observation group were significantly lower than those before treatment (all P <0.05), and the above indexes in observation group were significantly lower than those in control group <0.05). After treatment, albumin and hemoglobin in the observation group were significantly higher than those in the control group (P <0.05). Conclusion Losartan combined with α-ketoacid is an effective method for early diabetic nephropathy. It can help stabilize blood pressure, reduce urinary protein, delay renal dysfunction, and improve nutritional status of patients, which is beneficial to the progression of diabetic nephropathy.