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目的观察以厄贝沙坦片联合α-酮酸为主的药物治疗对早期糖尿病肾病疗效。方法饮食控制,控制蛋白质摄入量在0.6-0.8g·kg-1·d-1,低钠低磷饮食;口服降糖药或注射胰岛素,使血糖控制在理想水平;α-酮酸口服3次/d,4-8片/次,用餐期间整片吞服·控制血压,厄贝沙坦片0.15g·次-1·d-1。根据病情可增至0.3g.盆血者用促红细胞生长素皮下注射50-100IU/kg;连续治疗16周。结果 23例患者中,有2例近期治愈(8.6%),16例显效(69.6%),4例有效(17.3%),无效1例(4.3%),总有效率达到95.7%。对照组例22例患者中,近期治愈0例,4例显效(18.1%),13例有效(59.2%),无效5例(22.7%),总有效率达到77.3%,统计学上均有非常显著的差异(P<0.001)。结论糖尿病肾病临床上尚无理想防治方法,如何延缓和阻止糖尿病肾病的肾脏损害是关键,以厄贝沙坦片剂联合α-酮酸对早期糖尿病肾病的防治具有较好的疗效,针对早期糖尿病肾病的临床特点能有效的延缓和阻止病情的发展。结合我院诊治的糖尿病肾病的情况,疗效较佳,分析报道如下。
Objective To observe the effect of Irbesartan combined with α-keto acid on early diabetic nephropathy. Methods Diet control, control of protein intake 0.6-0.8g · kg-1 · d-1, low-sodium low-phosphorus diet; oral hypoglycemic agents or insulin injections, so that blood glucose control in the ideal level; α-keto acid oral 3 Times / d, 4-8 tablets / time, the whole meal swallowed during the control of blood pressure, irbesartan tablets 0.15g · times -1 · d-1. According to the disease can be increased to 0.3g. Echinocytosis patients with subcutaneous injection of 50-100IU / kg; continuous treatment for 16 weeks. Results Of 23 patients, 2 were cured recently (8.6%), 16 were markedly effective (69.6%), 4 were effective (17.3%) and 1 was ineffective (4.3%). The total effective rate was 95.7%. The control group of 22 cases of patients, the recent 0 cases were cured, 4 cases markedly effective (18.1%), 13 cases (59.2%), 5 cases (22.7%), the total effective rate was 77.3%, statistically significant Significant difference (P <0.001). Conclusion Diabetic nephropathy clinically no ideal method of prevention and treatment, how to delay and prevent the kidney damage of diabetic nephropathy is the key to irbesartan tablets combined with α-keto acid for the prevention and treatment of early diabetic nephropathy has a good effect, for early diabetes The clinical features of nephropathy can effectively delay and prevent the progression of the disease. Combined with the diagnosis and treatment of diabetic nephropathy in our hospital, the effect is better, the analysis reported below.