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目的:观察厄贝沙坦联合胰激肽原酶治疗老年早期糖尿病肾病(DN)的疗效。方法:72例早期DN患者随机分成3组,观察组(厄贝沙坦联合胰激肽原酶),ARB组(厄贝沙坦)及对照组各24例;观察12周,比较治疗前后患者尿微量白蛋白排泄率(UAER)、尿β2-微球蛋白(β2-MG)、平均动脉压(MAP)、血清肌酐(Scr)及糖化血红蛋白(HbA1c)变化。结果:治疗后观察组及ARB组UAER及尿β2-MG较治疗前显著下降(P<0.01),且较对照组显著降低(P<0.01),观察组较ARB组下降更为显著(P<0.01);3组治疗后MAP较治疗前均有明显下降(P<0.01),三组之间差异无显著性(P>0.05);治疗后观察组及ARB组Scr、HbA1c无明显变化(P>0.05)。结论:厄贝沙坦联合胰激肽原酶治疗老年早期DN疗效确切,可显著减少患者尿蛋白排出。
Objective: To observe the effect of irbesartan and pancreatic kallikrein in the treatment of senile early diabetic nephropathy (DN). Methods: Seventy-two patients with early stage DN were randomly divided into three groups: 24 cases in observation group (irbesartan combined with kallikrein), ARB group (irbesartan) and control group; 12 weeks after treatment, the patients before and after treatment UAER, β2-MG, MAP, Scr and HbA1c were measured. Results: After treatment, UAER and urinary β2-MG in the observation group and ARB group were significantly lower than those before treatment (P <0.01), and were significantly lower than those in the control group (P <0.01) (P <0.01). There was no significant difference between the three groups (P> 0.05). After treatment, the levels of Scr and HbA1c in the observation group and the ARB group had no significant change (P <0.01) > 0.05). Conclusion: Irbesartan combined with pancreatic kallikrein treatment of elderly early DN exact effect, can significantly reduce the urinary protein excretion.