摘要
目的探讨羟苯磺酸钙对糖尿病肾病患者的估算肾小球滤过率(estimated glomerular filtration rate,eGFR)下降速率的影响。方法回顾性分析2009年2月至2013年10月在我院规律随诊的糖尿病肾病患者337例,治疗组为糖尿病肾病患者144例,常规降糖药物治疗基础上加用羟苯磺酸钙胶囊口服(500 mg,每日3次),对照组为糖尿病肾病患者193例,予以常规降糖药物治疗。2组患者的初始慢性肾脏病(chronic kidney disease,CKD)分期为CKD1~3期,比较2组患者间月肾小球滤过率下降的情况。结果加用羟苯磺酸钙治疗的糖尿病肾病患者(治疗组)的月肾小球滤过率下降率(ΔeGFR)明显低于未加用羟苯磺酸钙治疗的糖尿病肾病患者(对照组)[(-0.33±2.43)ml/min比(0.19±2.24)ml/min,P<0.05]。依据患者初始eGFR进行CKD分期发现,在CKD3期时,治疗组的ΔeGFR明显低于对照组[(-0.98±1.55)ml/min比(-0.17±1.32)ml/min,P<0.05]。依据患者起始尿蛋白情况对治疗组进行分组比较发现,尿蛋白增多的患者ΔeGFR明显增高(P<0.05)。进一步对尿蛋白定量正常组进行比较发现,治疗组的ΔeGFR明显低于对照组[(-1.29±2.32)ml/min比(0.06±1.53)ml/min,P<0.01]。结论羟苯磺酸钙能改善糖尿病肾病患者肾功能,在CKD3期时更为明显,建议在尿蛋白定量正常时就开始加用羟苯磺酸钙治疗。
Objective To determine the effect of calcium dobesilate administration on the decline rate of glomerular filtration rate（GFR）in patients with diabetic nephropathy.Methods The retrospectively study included 337 diabetic nephropathy patients who were followed up from February 2009 to October 2013 in our hospital.144 patients with diabetic nephropathy served as treatment group.All the patients were given treatment to control blood glucose and the treatment group was treated with calcium dobesilate（500 mg,three times per day）.The patients were divided into CKD stages 1-3 according to the original eGFR,and the monthly decline rate of eGFR was compared between the two groups.Results The monthly decline rate of eGFR（ΔeGFR）in the diabetic nephropathy patients treated with calcium dobesilate（treatment group）was significantly lower than the patients treated without calcium dobesilate（control group）（-0.33±2.43 vs.0.19±2.24 ml/min,P〈0.05）.According to the original eGFR,we found that theΔeGFR in the treatment group was significantly lower than in the control group in the CKD stage 3（-0.98±1.55 vs.-0.17±1.32 ml/min,P〈0.05）.According to the original level of the urine protein,we found that theΔeGFR was higher in the patients with more urine protein（P〈0.05）.Comparing the ΔeGFR among the patients with normal 24-h urineprotein excretion,we found that the ΔeGFR in the treatment group was significantly lower.Conclusions Administration of the calcium dobesilate in patients with diabetic nephropathy is effective to the renal function,especially in the CKD stage 3.We suggest that calcium dobesilate is given to the patients when the 24-h urine protein excretion is normal.
出处
《临床肾脏病杂志》
2017年第12期731-734,共4页
Journal Of Clinical Nephrology
基金
湖北省自然科学基金面上项目(No.2014CFC1047)
武汉市卫生计生委科研项目(No.WG15A02)
武汉市科技局科研项目(No.201260523197-2)
关键词
羟苯磺酸钙
糖尿病肾病
慢性肾脏病
肾小球滤过率
Calcium dobesilate
Diabetic nephropathy
Chronic kidney disease
Glomerular fil-tration rate
