摘要
目的研究缬沙坦联合贝前列素钠治疗高龄糖尿病肾病(DN)患者的临床疗效和安全性。方法前瞻性研究,选择2014年1月至2015年12月接受治疗的高龄DN患者120例。用随机数表法分为对照组和实验组,每组各60例,对照组给予常规治疗联合贝前列素钠,实验组在对照组的基础上加用缬沙坦。比较两组患者的近远期疗效、肾功能指标、尿微量蛋白指标和安全性。结果实验组患者的总有效率(95.00%)明显高于对照组(78.33%),差异有统计学意义(P<0.05)。治疗前两组患者的肾功能指标水平无显著差异(P>0.05),治疗后两组患者的尿素氮(BUN)、胱抑素C(Cys C)、血清肌酸酐(Scr)和同型半胱氨酸(Hcy)水平均明显下降,实验组患者上述指标水平明显低于对照组,差异有统计学意义(P<0.05)。治疗前两组患者的尿微量蛋白指标水平无显著差异(P>0.05),治疗后两组患者的尿微量清蛋白/尿肌酸酐(ACR)、尿微量清蛋白(MAU)、尿β2微球蛋白(β2-MG)和24 h尿微量白蛋白(24 h-UMA)水平均明显下降,实验组患者上述指标水平明显低于对照组,差异有统计学意义(P<0.05)。随访一年后实验组有3例转为透析,对照组有10例转为透析,实验组转透析率(5.0%)明显低于对照组(16.7%),差异有统计学意义(P<0.05)。两组患者不良反应的发生率无显著差异(P>0.05)。结论缬沙坦联合贝前列素钠可以明显提高高龄DN患者的临床疗效,可以改善患者的肾功能,减轻尿蛋白,安全性较好,值得在临床推广应用。
Objective To explore the clinical efficacy and safety of valsartan combined with sodium beraprost in the treatment of elderly patients with diabetic nephropathy. Methods A total of 120 elderly patients with diabetic nehropathy treated during January 2014 to December 2015 were listed for this prospective study. They were randomly divided into control group and experimental group,60 cases in each group. Pa-tients in control group were treated with conventional treatment combined with sodium beraprost,and patients in experimental group were treated with valsartan on the basis of treatment in control group. The short and long - term efficacy,indicators of renal functions,indicator of urinary mi-croalbumin and safety were compared between these two groups. Results The total effective rate of patients in experimental group （95. 00%）was significantly higher （78. 33%）,and the difference was significant. There was no significant difference in the levels of renal function between these two groups before treatment （P 〉 0. 05）. After treatment,the levels of urea nitrogen （BUN）,cystatin crospectivel （CysC）,serum creatinine （Scr）and homocysteine （Hcy）were significantly decreased,these above indicators in patients of experimental group were significantly lower than those of patients in control group,and the difference was statistically significant （P 〈 0. 05）. There was no significant difference in level of urina-ry microprotein between these two groups before treatment （P 〉 0. 05）. After treatment,the levels of urinary micro - albumin,urinary creatinine, urinary albumin and beta 2 microglobulin and 24 h microalbuminuria were significantly decreased,and their levels in experimental group were sig-nificantly lower than those of control group,and the difference was statistically significant （P 〈 0. 05）. After one year of follow - up in experi-mental group,3 cases were transferred to dialysis,10 cases in control group were transferred to dialysis,the rate of transference to dialysis （5%） in patients of experimental group was significantly lower than that of patients in control group （16. 7%）,the difference was statistically significant （P 〈 0. 05）,and the difference in incidence of adverse reactions between patients of these 2 groups was not significant （P 〉 0. 05）. Conclusion Valsartan combined with sodium beraprost can significantly raise the clinical efficacy of elderly patients with DN,and improve their renal func-tions and reduce the amount of urinary protein,hence it is safe and worthy to be applied in clinical practice.
出处
《临床和实验医学杂志》
2018年第1期106-109,共4页
Journal of Clinical and Experimental Medicine
关键词
糖尿病肾病
缬沙坦
贝前列素钠
Diabetic nephropathy Valsartan Sodium beraprost
