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目的探讨贝那普利联合丹参注射液、螺内酯对Ⅳ期糖尿病肾病患者肾功能影响。方法Ⅳ期糖尿病肾病患者80例,随机分为4组,即对照组,贝那普利组(A组)、贝那普利联合丹参注射液组(B组)、贝那普利联合丹参注射液及螺内酯组(C组);各组均每日口服双氢克尿噻片25 mg,共治疗4周,治疗前、后均测定血压、血糖、糖化血红蛋白、血肌酐(serum creatinine,Scr)、尿蛋白及肾小球滤过率(glomerular filtration rate,GFR)。结果治疗前Scr、尿蛋白、血压、GFR 4组比较无显著性差异(P>0.05),治疗后Scr、尿蛋白A、B、C组与对照组比较明显下降(P<0.01),GFR明显升高(P<0.05);治疗后Scr、尿蛋白B组与A组比较明显下降(P<0.05),而GFR明显升高(P<0.05)。C组治疗后Scr、尿蛋白及血压较治疗前显著下降(P<0.01),GFR明显升高(P<0.01);C组治疗后的Scr、尿蛋白、血压与A组比较,明显下降(P<0.01),而GFR明显升高(P<0.01);C组与B组比较,治疗后的Scr、尿蛋白显著降低(P<0.05),GFR显著升高(P<0.05)。结论贝那普利联合丹参注射液、螺内酯治疗Ⅳ期糖尿病肾病患者可明显提高其GFR,降低其尿蛋白和Scr,为治疗Ⅳ期糖尿病肾病提供了新的方案。
Objective To investigate the effects of benazepril combined with Salvia injection and spironolactone on renal function in patients with stage Ⅳ diabetic nephropathy. Methods Eighty patients with stage Ⅳ diabetic nephropathy were randomly divided into 4 groups: control group, benazepril group (group A), benazepril combined with salvia miltiorrhiza injection group (group B), benazepril combined with salvia miltiorrhiza injection Liquid and spironolactone group (group C). Hydrochlorothiazide 25 mg was given orally daily for 4 weeks in each group. Blood pressure, blood glucose, glycosylated hemoglobin, serum creatinine (Scr) were measured before and after treatment. , Urinary protein and glomerular filtration rate (GFR). Results There was no significant difference in Scr, urinary protein, blood pressure and GFR 4 before treatment (P> 0.05). After treatment, Scr, urine protein A, B and C decreased significantly compared with the control group (P <0.01) (P <0.05). After treatment, the levels of Scr and urinary protein B in group B were significantly lower than those in group A (P <0.05), while GFR was significantly increased (P <0.05). Scr, urine protein and blood pressure in group C were significantly lower than those before treatment (P <0.01), GFR was significantly increased (P <0.01); Scr, urine protein and blood pressure in group C were significantly decreased compared with those in group A (P <0.01), while the GFR was significantly increased (P <0.01). Compared with group B, the Scr and urinary protein of group C were significantly decreased (P <0.05) and GFR was significantly increased (P <0.05). Conclusion Benaipril combined with Danshen injection and spironolactone treatment of patients with stage Ⅳ diabetic nephropathy can significantly improve their GFR, reduce urinary protein and Scr, and provide a new scheme for the treatment of stage Ⅳ diabetic nephropathy.