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目的 :探讨血液流变性改善剂己酮可可碱对老年糖尿病肾病早期的治疗作用。方法 :将 10 6例 型糖尿病伴有微量白蛋白尿患者随机分为 2组治疗 ,己酮可可碱组 6 6例 ,卡托普利 (开博通 )组 40例 ,治疗期为 6个月。结果 :2组治疗后尿总蛋白 (U TP)及尿白蛋白排泄率 (U AER)均明显降低〔己酮可可碱组 U TP从 (0 .2 1± 0 .0 6 ) g/ 2 4h 降至 (0 .12± 0 .0 4) g/ 2 4h,P<0 .0 1;U AER从 (132 .6 5± 5 3.5 8) μg/ min降至 (5 5 .82±2 7.17) μg/ m in,P<0 .0 1。卡托普利组 UTP从 (0 .19± 0 .0 6 ) g/ 2 4h降至 (0 .13± 0 .0 5 ) g/ 2 4h,P<0 .0 1;UAER从 (115 .2 6± 5 3.35 )μg/ min降至 (75 .6 2± 43.34)μg/ min,P<0 .0 1〕。肌酐清除率 (CCr)有所改善〔己酮可可碱组从 (1.37± 0 .16 ) m l· s- 1 · 1.73 m- 2 增到 (1.48± 0 .2 2 ) ml· s- 1 · 1.73 m- 2 ,P<0 .0 5 ;卡托普利组从 (1.33±0 .2 7) ml· s- 1 · 1.73 m- 2 )增到 (1.43± 0 .34) ml· s- 1 · 1.73 m- 2 ,P<0 .0 5〕,治疗后 2组间比较无明显差异(P>0 .0 5 )。2组对血压和血脂都有一定良好的影响。结论 :己酮可可碱有减少尿蛋白、改善肾功能的作用 ,对老年 型糖尿病早期肾病有确切的治疗作用。
Objective: To investigate the early therapeutic effect of pentoxifylline, a hemorheological modifier, on senile diabetic nephropathy. Methods: A total of 106 patients with diabetes mellitus and microalbuminuria were randomly divided into 2 groups: 6 in pentoxifylline group and 40 in captopril group. The treatment period was 6 months . Results: The urinary total protein (UTP) and urinary albumin excretion rate (U AER) of the two groups were significantly decreased [UTP of pentoxifylline group from (0.21 ± 0.06) g / 24h To (0.12 ± 0.04) g / 2 4h, P <0.01; UER decreased from (132.6 ± 5 3.58) μg / min to (55.8 ± 2 7.17 ) μg / m in, P <0.01. In the captopril group, the UTP decreased from (0.19 ± 0. 0 6) g / 2 4h to (0 .13 ± 0. 05) g / 2 4h, P <0.01; 2 6 ± 5 3.35) μg / min to (75.62 ± 43.34) μg / min, P <0.01). Creatinine clearance (CCr) improved (pentokine-theobromine increased from (1.37 ± 0.16) ml · s-1 · 1.73 m-2 to (1.48 ± 0.22) ml · s-1 · 1.73 (1.43 ± 0.34) ml · s-1 in the captopril group from (1.33 ± 0.27) ml · s-1 · 1.73 m-2 to m-2, P <0.05 · 1.73 m-2, P <0.05). There was no significant difference between the two groups after treatment (P> 0.05). Both groups had some good effects on blood pressure and blood lipids. CONCLUSION: Pentoxifylline can reduce urinary protein and improve renal function, and has an exact therapeutic effect on early diabetic nephropathy in elderly patients.