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目的观察舒洛地特联合缬沙坦治疗对高血压肾损害患者肾功能和尿蛋白的影响。方法 60例高血压肾损害患者均进行基础治疗,然后随机分为两组,对照组30例,每天晨服缬沙坦胶囊80 mg;治疗组30例,在对照组治疗基础上加服舒洛地特胶囊250LSU,每日2次。两组疗程均为3个月。检测治疗前后血肌酐(Scr)、尿素氮(BUN)、血尿酸(UA)、血清光抑素C(cystatin C)、24 h尿蛋白、尿β2-微球蛋白(β2-MG)、尿α1微球蛋白(α1-MG)、尿N-乙酰-β-D葡萄糖苷酶(NAG)。结果与治疗前相比,两组治疗后BUN、Cr、UA无明显变化(P>0.05),cystatin C均明显减少(P<0.01),而治疗组血cystatin C减少更加明显(P<0.01);两组治疗后24 h尿蛋白定量、尿α1-MG、β2-MG、NAG均明显减少(P<0.01),而治疗组24 h尿蛋白定量、尿α1-MG、β2-MG、NAG减少更加明显(P<0.01)。结论舒洛地特联合缬沙坦治疗比单纯应用缬沙坦治疗能够更有效地降低2型糖尿病肾病患者的尿蛋白,对肾脏具有良好的保护作用。
Objective To observe the effect of sulodexide combined with valsartan on renal function and urinary protein in patients with hypertensive renal damage. Methods Sixty patients with hypertensive renal impairment were treated with basic therapy and then randomly divided into two groups. The control group was given 30 mg valsartan capsules daily, and the treatment group was given 30 mg valsartan daily. On the basis of the control group, To special capsules 250LSU, 2 times a day. Two groups of treatment are 3 months. Serum creatinine (Scr), blood urea nitrogen (BUN), serum uric acid (UA), serum cystatin C, 24 h urinary protein, urinary β2-microglobulin (β2-MG) Microglobulin (α1-MG), urine N-acetyl-β-D-glucosidase (NAG). Results Compared with those before treatment, the levels of BUN, Cr and UA had no significant change (P> 0.05) and cystatin C decreased significantly (P <0.01), while the decrease of serum cystatin C in treatment group was more obvious (P <0.01) ; Urinary protein, urinary α1-MG, β2-MG and NAG were significantly decreased in both groups 24 h after treatment (P <0.01), while 24 h urinary protein excretion, urinary α1-MG, β2-MG and NAG decreased More obvious (P <0.01). Conclusion The combination of sulodentid and valsartan can lower urinary protein in patients with type 2 diabetic nephropathy more effectively than valsartan alone and has a good protective effect on the kidney.