螺内酯与ACEI及ARB联合应用对早期糖尿病肾病患者尿白蛋白排泄率的影响

摘要

目的：探讨螺内酯与ACEI及ARB联合应用对早期糖尿病肾病患者尿白蛋白排泄率的影响。方法：选取2013年1月-2014年1月在笔者所在医院进行治疗的78例患者，随机分为对照组和治疗组，对照组采用ACEI及ARB联合用药进行治疗，治疗组在对照组的基础上采用螺内酯进行治疗，治疗2个月后，观察两组患者血浆白蛋白(Alb)、尿蛋白排泄率(UAER)、肌酐(SCr)、电解质的变化。结果：治疗后，两组患者的UAER均降低，但是治疗组明显优于对照组，差异有统计学意义(P<0.05)；两组患者的Alb、SCr及电解质的变化均不明显，差异无统计学意义(P>0.05)。结论：螺内酯与ACEI及ARB联合应用治疗早期糖尿病肾病患者，其尿蛋白排泄率明显降低，具有较好的临床效果，值得在临床上推广使用。%Objective:To investigate Spironolactone and ACEI and ARB combined impact of early diabetic nephropathy and urinary albumin excretion rate applications.Method:From January 2013 to January 2014 in our hospital for treatment of 78 patients were randomly divided into the control group and the treatment group.The control group was given ACEI and ARB combination therapy for treatment,on the basis of the control group the treatment group was given Spironolactone treatment,after 2 months of treatment,patients were observed plasma albumin(Alb),urinary albumin excretion rate(UAER),creatinine(SCr), and electrolyte changes.Result:After treatment,the UAER of two groups were lower,but the treatment group was lower than the control group,the difference was significant(P<0.05).Alb,SCr and electrolyte changes of the two groups were not significant,the difference was not statistically significant(P>0.05). Conclusion:Spironolactone combination with ACEI and ARB treatment of early diabetic nephropathy,urinary albumin excretion rate is significantly lower,with better clinical results and should be introduced in clinical practice.