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目的观察体外反搏联合胰激肽原酶肠溶片治疗糖尿病肾病的效果。方法 2011年5月—2013年6月我院住院或门诊的糖尿病肾病患者40例,随机分为对照组和观察组各20例。所有患者均给予糖尿病及优质低蛋白饮食,限制剧烈运动,应用胰岛素控制血糖,应用不影响尿蛋白排泄的降压药。对照组在上述治疗基础上加用胰激肽原酶口服,240 U/次,3次/d,连服35 d。观察组在对照组治疗基础上予增强型体外反搏,治疗压力0.03~0.045MPa,1 h/d,共35 d。观察两组治疗前后24 h尿蛋白定量、尿白蛋白排泄率(urinary albumin excretion rate,UAER)、Scr、BUN、SBP、DBP等指标的变化。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果两组24 h尿蛋白定量、UAER明显降低(P<0.05),治疗后观察组较对照组24 h尿蛋白定量、UAER明显降低(P<0.05)。结论增强型体外反搏联合胰激肽原酶肠溶片治疗能更有效的降低DN患者的尿蛋白,有临床应用的价值,值得进一步研究和推广。
Objective To observe the effect of extracorporeal counterpulsation combined with kallikrein enteric-coated tablets in the treatment of diabetic nephropathy. Methods From May 2011 to June 2013, 40 patients with diabetic nephropathy hospitalized or outpatient in our hospital were randomly divided into control group and observation group with 20 cases each. All patients were given diabetes and high-quality low-protein diet, limiting strenuous exercise, the application of insulin to control blood sugar, the application does not affect the urinary protein excretion of antihypertensive drugs. Control group in addition to the above treatment with pancreatic kallikrein oral administration, 240 U / times, 3 times / d, and even served 35 d. On the basis of the control group, the observation group was given enhanced external counterpulsation. The treatment pressure was 0.03-0.045 MPa for 1 h / d for 35 days. Urinary albumin excretion rate (UAER), Scr, BUN, SBP, DBP and other indicators of 24 h after treatment were observed in two groups before and after treatment. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The 24 h urinary protein and UAER in the two groups were significantly decreased (P <0.05). The urinary protein in 24 h after treatment in the observation group was significantly lower than that in the control group (P <0.05). Conclusions Enhanced EECP combined with pancreatic kallikrein enteric-coated tablets is more effective in reducing urinary protein in patients with DN, and has clinical value. It is worth further study and promotion.