瑞舒伐他汀联合羟苯磺酸钙治疗Ⅲ期和Ⅳ期糖尿病肾病的临床效果

摘要

目的 观察瑞舒伐他汀联合羟苯磺酸钙治疗Ⅲ～Ⅳ期糖尿病肾病(DN)的临床效果.方法 选取2016年1月至2018年1月浙江省台州市立医院收治的DN患者140例为研究对象.完全随机分为对照组与观察组,各70例.对照组在常规治疗基础上给予瑞舒伐他汀口服治疗;观察组在常规治疗基础上给予瑞舒伐他汀及羟苯磺酸钙口服治疗,分析2组患者的临床效果及胰岛素抵抗的改善情况.结果 治疗前2组肾功能、血糖、胰岛功能相关指标差异均无统计学意义(均P＞0.05).治疗后,2组血尿酸、稳态模型胰岛β细胞功能指数水平均高于治疗前,且观察组高于对照组[(388±25) μ,mol/L比(367±25)μmol/L、(44±7)比(39±6)];血肌酐、血尿素氮、空腹血糖、餐后2h血糖、糖化血红蛋白、稳态模型胰岛素抵抗指数水平均低于治疗前,且观察组低于对照组[(333±42)μmol/L比(391±26) μmol/L、(17±4)mmol/L比(20±6)mmol/L、(6.4±1.1) mmol/L比(7.3±1.1) mmol/L、(9.4±1.8) mmol/L比(10.0±2.5) mmol/L、(6.0±1.2)％比(6.7±1.3)％、(2.1±0.5)比(2.5±0.9)],差异均有统计学意义(均P＜0.05).结论 瑞舒伐他汀联合羟苯磺酸钙可有效改善DN患者的肾功能,且能改善其胰岛素抵抗和胰岛β细胞功能.%Objective The observe the clinical effect of rosuvastatin combined with calcium dobesilate on stage Ⅲ-Ⅳ diabetic nephropathy.Methods A total of 140 patients with diabetic nephropathy (DN) admitted to Taizhou Municipal Hospital,Zhejiang Province from January 2016 to January 2018 were randomly divided into control group and observation group,with 70 cases in each group.The control group took rosuvastatin and the observation group took rosuvastatin plus calcium dobesilate on the basis of routine treatment.Clinical efficacy and insulin resistance of were analyzed after treatment.Results There were no significant differences of renal function,blood sugar and islet function indexes between groups before treatment (all P ＞ 0.05).After treatment,levels of serum uric acid and homeostatic model assessment-β cell function index significantly increased in both groups;the levels in observation group were significantly higher than those in control group [(388 ± 25) μmol/L vs (367 ± 25) μμmol/L,(44 ± 7) vs (39 ± 6)].Levels of serum creatinine,blood urea nitrogen,fasting blood glucose,postprandial 2 h blood sugar,glycosylated hemoglobin and homeostatic model assessment-insulin resistance significantly decreased in both groups;the levels in observation group were significantly lower than those in control group [(333 ± 42) μmol/L vs (391 ± 26) μmol/L,(17 ± 4) mmol/L vs (20 ±6)mmol/L,(6.4±1.1) mmol/L vs (7.3 ±1.1) mmol/L,(9.4 ± 1.8) mmol/L vs (10.0 ±2.5)mmol/L,(6.0±1.2)％ vs (6.7±1.3)％,(2.1 ±0.5) vs (2.5 ±0.9)](all P＜0.05).Conclusion Rosuvastatin combined with calcium dobesilate can effectively improve renal function,insulin resistance and islet β cell function in patients with DN.