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目的比较舒洛地特单用或与薄芝糖肽合用对早期糖尿病肾病患者尿白蛋白排泄率(UAER)的影响。方法早期糖尿病肾病患者86例,随机分为两组,每组43例。在常规治疗的基础上,对照组给予舒洛地特注射液2 m L,肌内注射,qd,连续15 d后改口服,舒洛地特软胶囊1粒,po,bid,连续35 d。观察组在对照组治疗基础上加用薄芝片,3片,po,tid,连续50 d。两组均为每4个月治疗1次,1年3次。观察两组患者UAER、血清胱抑素C(CysC)水平和糖尿病肾病进展,记录不良反应发生情况。结果对照组完成41例,观察组完成40例。治疗后观察组UAER、CysC降低(29.81±10.47)μg·min~(-1)、(0.71±0.57)mg·L~(-1),对照组降低(15.91±10.78)μg·min~(-1)、(0.58±0.36)mg·L~(-1),与治疗前比较均有显著差异(P<0.05),且观察组下降幅度大于对照组(P<0.05)。观察组糖尿病肾病分期情况优于对照组(P<0.05),两组均无严重不良反应发生。结论舒洛地特联合薄芝糖肽可降低早期糖尿病肾病患者UAER,并在一定程度上延缓糖尿病肾病进展。
Objective To compare the effects of sulodexide alone or in combination with baozhi glycopeptide on urinary albumin excretion (UAER) in patients with early diabetic nephropathy. Methods Early diabetic nephropathy in patients with 86 cases were randomly divided into two groups, 43 cases in each group. On the basis of routine treatment, the control group was given Shu Luiterte injection 2 m L, intramuscular injection, qd, continuous oral administration of 15 days, Shu Luoterte soft capsules 1, po, bid, for 35 consecutive days. Observation group in the control group on the basis of the treatment plus thin Zhi, 3, po, tid, continuous 50 d. Two groups were treated once every 4 months, 1 year 3 times. The levels of UAER, serum cystatin C (CysC) and diabetic nephropathy were observed in two groups. The incidence of adverse reactions was recorded. Results The control group completed 41 cases, the observation group completed 40 cases. After treatment, the UAER and CysC of the observation group decreased (29.81 ± 10.47) μg · min -1 and (0.71 ± 0.57) mg · L -1, while those of the control group decreased 15.91 ± 10.78 μg · min -1 1 and 0.58 ± 0.36 mg · L -1, respectively, which were significantly lower than those before treatment (P <0.05), and the decrease in the observation group was greater than that in the control group (P <0.05). The staging of diabetic nephropathy in observation group was better than that of control group (P <0.05), and no serious adverse reactions occurred in both groups. Conclusions Both sulodexide and bilobatin can reduce UAER in patients with early stage diabetic nephropathy and delay the progression of diabetic nephropathy to a certain extent.