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目的探讨缬沙坦胶囊在2型糖尿病肾病早期中的应用效果。方法选择2011年1月—2012年12月治疗的2型糖尿病肾病早期患者80例,根据随机数字表法分为观察组和对照组各40例,两组均给予常规治疗,所有患者均需要保持良好的生活习惯和方式配合药物治疗以促进治疗效果;控制血糖:根据患者情况使用降糖药物,如胰岛素等;扩血管,改善微循环:前列地尔注射液10μg加入0.9%氯化钠注射液100 ml静脉滴注,1次/d;降血压:卡托普利25 mg口服,1次/d,或加硝苯地平控释片10 mg口服,1次/d;降血脂:辛伐他汀片10 mg口服,1次/晚;对症处理:伴水肿者加利尿剂。观察组在常规治疗的基础上加缬沙坦胶囊80 mg口服,1次/d。两组均治疗12周评价疗效,比较两组血钾、糖化血红蛋白、低密度脂蛋白胆固醇、24 h尿蛋白量及血压。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果总有效率观察组95.0%,对照组70.0%,比较差异有统计学意义(P<0.05)。治疗后观察组24 h尿蛋白量、收缩压、舒张压[(1.05±0.57)g、(121.47±7.53)、(78.73±7.36)mm Hg(1 mm Hg=0.133 kPa)]与对照组[(1.50±0.79)g、(133.63±8.89)、(87.84±8.04)mm Hg]比较差异均有统计学意义(均P<0.05)。结论对于早期2型糖尿病肾病患者,在常规治疗的基础上加用缬沙坦胶囊,可显著降低24 h尿蛋白量,起到保护肾脏作用。
Objective To investigate the effect of valsartan in the early stage of type 2 diabetic nephropathy. Methods 80 patients with type 2 diabetic nephropathy treated from January 2011 to December 2012 were randomly divided into observation group (40 cases) and control group (40 cases) according to the random number table. Both groups were given routine treatment and all patients needed to maintain Good habits and ways with the drug treatment to promote the treatment effect; Control of blood sugar: According to the patient’s condition using hypoglycemic drugs such as insulin; vasodilators to improve microcirculation: Alprostadil 10μg 0.9% sodium chloride injection 100 ml intravenous drip, 1 time / d; lowering blood pressure: captopril 25 mg orally, once / d, or nifedipine 10 mg orally, once / d; Tablet 10 mg orally, 1 / night; symptomatic treatment: with diuretic plus diuretics. The observation group on the basis of conventional treatment with valsartan 80 mg orally, 1 time / d. Both groups were treated for 12 weeks to evaluate the curative effect. The levels of serum potassium, glycosylated hemoglobin, low density lipoprotein cholesterol, 24 h urine protein and blood pressure were compared between the two groups. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The total effective rate was 95.0% in observation group and 70.0% in control group, with significant difference (P <0.05). After treatment, the 24 h urine protein, systolic blood pressure, diastolic blood pressure [(1.05 ± 0.57) g, (121.47 ± 7.53) and (78.73 ± 7.36) mm Hg 1.50 ± 0.79) g, (133.63 ± 8.89) and (87.84 ± 8.04) mm Hg, respectively (all P <0.05). Conclusion For patients with early type 2 diabetic nephropathy, adding valsartan capsule on the basis of routine treatment can significantly reduce the amount of 24-hour urine protein and play a role in protecting the kidneys.