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目的:探讨替米坦联合阿托伐他汀治疗糖尿病肾病(DN)的疗效及机制。方法:选择糖尿病肾病60例,随机分为治疗组和对照组各30例,对照组单用替米沙坦治疗,治疗组应用替米沙坦联合阿托伐他汀治疗,疗程6个月。治疗前后观察TC、TG、尿微量白蛋白(MALB)、24h尿蛋白、Scr、BUN、C-反应蛋白、IL-6的值。结果:治疗前,两组TC、TG、尿微量白蛋白(MALB)、24h尿蛋白、Scr、BUN、C-反应蛋白、IL-6的值比较无明显差异(P>0.05),治疗6月后,与治疗前比较,除TC、TG外,两组患者的尿微量白蛋白(MALB)、24h尿蛋白、Scr、BUN、C-反应蛋白、IL-6的值下降(P<0.01),治疗组的TC、TG、尿微量白蛋白(MALB)、24h尿蛋白、Scr、BUN、C-反应蛋白、IL-6值较对照组低,差异有统计学意义(P<0.01)。结论:采用替米沙坦和阿托伐他汀治疗糖尿病肾病具有降血脂、减少尿蛋白、改善肾功能、延缓病情进展的作用。
Objective: To investigate the efficacy and mechanism of telmisartan combined with atorvastatin in the treatment of diabetic nephropathy (DN). Methods: Sixty diabetic nephropathy patients were randomly divided into treatment group (30 cases) and control group (30 cases). The control group was treated with telmisartan alone. The treatment group was treated with telmisartan and atorvastatin for 6 months. TC, TG, urinary microalbumin (MALB), 24h urinary protein, Scr, BUN, C-reactive protein and IL-6 were observed before and after treatment. Results: There was no significant difference in TC, TG, MALB, 24h urinary protein, Scr, BUN, C-reactive protein and IL-6 between the two groups before treatment After treatment, the levels of urine microalbumin (MALB), 24h urine protein, Scr, BUN, C-reactive protein and IL-6 in the two groups were decreased (P <0.01) The TC, TG, MALB, 24h urinary protein, Scr, BUN, C-reactive protein and IL-6 in the treatment group were lower than those in the control group, with statistical significance (P <0.01). Conclusion: The treatment of diabetic nephropathy with telmisartan and atorvastatin has the effects of lowering blood lipid, reducing urine protein, improving renal function and slowing the progression of the disease.