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目的探讨胰激肽原酶联合来氟米特和缬沙坦治疗糖尿病肾病(DN)的临床效果。方法选取泗阳县人民医院2015年5月—2016年5月收治的DN患者100例,按照治疗方式不同分为对照组和治疗组,各50例。患者入院后均给予常规对症治疗,对照组患者给予胰激肽原酶和缬沙坦治疗,治疗组患者在对照组基础上联合来氟米特治疗,两组患者均持续治疗3个月。比较两组患者的临床疗效,治疗前后临床指征(尿微量清蛋白、三酰甘油、血肌酐、总胆固醇、尿素氮及空腹血糖)变化情况及不良反应发生情况。结果治疗组患者治疗总有效率高于对照组(P<0.05)。治疗前,两组患者尿微量清蛋白、三酰甘油、血肌酐、总胆固醇、尿素氮及空腹血糖比较,差异无统计学意义(P>0.05);治疗后,治疗组患者尿微量清蛋白、三酰甘油、血肌酐、总胆固醇、尿素氮及空腹血糖低于对照组(P<0.05)。治疗组患者不良反应发生率低于对照组(P<0.05)。结论胰激肽原酶、来氟米特和缬沙坦联合治疗DN可有效提高患者临床疗效,改善患者临床指征,且不良反应少。
Objective To investigate the clinical efficacy of pancreatic kallikrein combined with leflunomide and valsartan in the treatment of diabetic nephropathy (DN). Methods 100 cases of DN patients who were treated in Siyang County People’s Hospital from May 2015 to May 2016 were divided into control group and treatment group according to different treatment methods, 50 cases in each group. All patients were given conventional symptomatic treatment after admission. Patients in the control group were given pancreatic kallikrein and valsartan. The patients in the treatment group were treated with leflunomide on the basis of the control group. Both groups were treated for 3 months. The clinical curative effect, clinical indications (urine microalbumin, triglyceride, serum creatinine, total cholesterol, urea nitrogen and fasting blood glucose) before and after treatment were compared between the two groups and the occurrence of adverse reactions. Results The total effective rate of treatment group was higher than that of control group (P <0.05). Before treatment, the urinary albumin, triglyceride, serum creatinine, total cholesterol, blood urea nitrogen and fasting blood glucose in the two groups had no significant difference (P> 0.05). After treatment, the urinary albumin, Triglyceride, serum creatinine, total cholesterol, blood urea nitrogen and fasting blood glucose were lower than those of the control group (P <0.05). The incidence of adverse reactions in the treatment group was lower than that in the control group (P <0.05). Conclusions The combination of pancreatic kallikrein, leflunomide and valsartan in the treatment of DN can effectively improve the clinical curative effect, improve the clinical indications of patients, and with less adverse reactions.