摘要
目的:探究低分子肝素钠联合依那普利对糖尿病肾病患者尿蛋白、肾功能及血液系统的影响.方法:选取2016年2月—2017年7月我院收治的68例糖尿病肾病患者为研究对象,按随机数字表法分为观察组和对照组,各34例,对照组给予常规治疗,观察组在对照组基础上给予注射用低分子肝素钠(皮下注射,2500~5000 IU/d)联合依那普利片(10 mg,qd)治疗,比较两组疗效及治疗前后24 h尿蛋白、肾功能、凝血功能和血脂功能指标水平.结果:观察组总有效率高于对照组,差异有统计学意义(P<0.05);治疗后观察组24 h尿蛋白、尿素氮(BUN)、血肌酐(Scr)水平较治疗前明显下降,且低于对照组,肾小球滤过率(eGFR)水平较治疗前明显提升,且高于对照组,差异有统计学意义(P<0.05);治疗后观察组凝血酶原时间(PT)、纤维蛋白原(FIB)水平较治疗前明显下降,活化部分凝血活酶时间(APTT)水平较治疗前明显上升,其中FIB和APTT的改善程度比对照组更为显著,差异有统计学意义(P<0.05);治疗后观察组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)水平较治疗前明显下降,且低于对照组,高密度脂蛋白(HDL-C)水平较治疗前明显升高,差异有统计学意义(P<0.05).结论:低分子肝素钠和依那普利联合治疗糖尿病肾病的疗效显著,可减少患者蛋白尿,调节血脂和凝血系统等多个环节并改善肾脏功能,延缓疾病进展,值得临床推广.
Objective:To explore the effect of low molecular weight heparin sodium combined with enalapril on urine protein,renal functions and blood systems in patients with diabetic nephropathy.Methods:68 patients with diabetic nephropathy admitted to our hospital from February 2016 to July 2017 were selected as subjects investigated,and they were randomly divided into an observation group and a control group,34 cases each.The patients in the control group were given conventional treatment,and the patients in the observation group were treated with low molecular weight heparin sodium(subcutaneous injection,2 500~5 000 IU/d)combined with enalapril tablets(10 mg,qd)on the basis of the control group.The efficacy,24 h urine protein and the indexes of renal functions,coagulation functions and blood lipid functions before and after treatment were compared between the two groups.Results:The total effective rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The levels of 24 h urine protein,urea nitrogen(BUN)and serum creatinine(Scr)in the observation after treatment were lower than those before treatment,and lower than those in the control group,while the level of glomerular filtration rate(eGFR)was higher than that before treatment,and higher than that in the control group,with statistically significant differences(P<0.05).The levels of prothrombin time(PT)and fibrinogen(FIB)in the observation group after treatment were significantly lower than those before treatment,while the level of activated partial thromboplastin time(APTT)was significantly higher than that before treatment,wherein the improvement of FIB and APTT was better than that in the control group,with statistically significant differences(P<0.05).The levels of total cholesterol(TC),triglyceride(TG)and low-density lipoprotein(LDL-C)in the observation group after treatment were significantly lower than those before treatment,and lower than those in the control group,while the level of HDL-C was significantly higher than that before treatment,with statistically significant differences(P<0.05).Conclusion:Low molecular weight heparin sodium combined with enalapril has a significant effect in the treatment of diabetic nephropathy,which can reduce proteinuria,regulate blood lipids and coagulation systems and other links,improve renal functions and delay disease progression,and is worth popularizing.
作者
沈春燕
Shen Chun-yan(Xinyang Central Hospital,Xinyang Henan 464000,China)
出处
《中国合理用药探索》
CAS
2019年第6期71-74,共4页
Chinese Journal of Rational Drug Use
关键词
低分子肝素钠
依那普利
糖尿病肾病
尿蛋白
Low Molecular Weight Heparin Sodium
Enalapril
Diabetic Nephropathy
Urine Protein
