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目的评估普罗布考(probucol)延缓糖尿病肾病(diabetic nephropathy,DN)进展的疗效。方法将102例临床出现白蛋白尿(尿微量白蛋白>1.9 mg/dl)的2型糖尿病患者,在常规药物治疗的基础上,分成普罗布考组(普罗布考500 mg/d,n=51)和对照组(n=51),随访6个月检测患者血压、血脂(TB、TG、LDL-c、HDL-c)、肾功(s-Cr、BUN、cys-c)、尿蛋白(尿微量白蛋白、24 h尿蛋白定量)、糖化血红蛋白(HbA1c)、超敏C反应蛋白(hs-CRP)、肝功(AST、ALT、GGT)并作统计学分析。结果随访期间,普罗布考治疗组失访5例,对照组失访3例。①普罗布考组治疗后血脂(TC、TG、LDL-c)、cys-c、hs-CRP均较治疗前和对照组均明显下降(P<0.05),并且肾功(s-Cr、BUN)、尿微量白蛋白、24 h尿蛋白定量的增加值普罗布考组明显低于对照组(P<0.05)。②在ARB/ACEI类药物(n=48)用药的基础上,普罗布考治疗更能降低患者cys-c、hs-CRP、24 h尿蛋白定量以及尿微量白蛋白增加水平(P<0.05)。结论普罗布考可以改善糖尿病肾病患者尿蛋白以及肾功能情况,对DN进展具有延缓作用,若联合使用ARB/ACEI类药物,对糖尿病肾病的防治会产生协同作用。
Objectives To evaluate the efficacy of probucol in delaying the progression of diabetic nephropathy (DN). Methods 102 type 2 diabetic patients with albuminuria (urinary albumin> 1.9 mg / dl) were divided into probucol group (probucol 500 mg / d, n = 51) and control group (n = 51). Blood pressure, serum lipids (TB, TG, LDL-c and HDL-c) (Urinary microalbuminuria, 24 h urinary protein), HbA1c, hs-CRP, AST, ALT and GGT were measured and analyzed statistically. Results During the follow-up period, probucol treatment group lost 5 cases and control group lost 3 cases. (1) Serum lipids (TC, TG, LDL-c), cys-c, hs-CRP in probucol group were significantly lower than those before treatment and control group ), Urinary microalbuminuria, and 24 h urinary protein in probucol group were significantly lower than those in control group (P <0.05). On the basis of ARB / ACEI drugs (n = 48), probucol treatment reduced the levels of cys-c, hs-CRP, 24 h urine protein and urine microalbumin (P <0.05) . Conclusion Probucol can improve urinary protein and renal function in patients with diabetic nephropathy, which may delay the progression of DN. If combined with ARB / ACEI drugs, it will have synergistic effect on the prevention and treatment of diabetic nephropathy.