替米沙坦联合阿魏酸钠治疗2型糖尿病早期肾病临床观察

摘要

目的：探讨替米沙坦联合阿魏酸钠治疗2型糖尿病早期肾病(DN)的临床疗效。方法：将120例DN患者随机分为治疗组和对照组，各60例，两组基础治疗相同，治疗组在对照组常规治疗基础上加用阿魏酸钠和替米沙坦治疗，治疗4周后观察两组患者血脂、血浆胱抑素C(Cys C)、内皮素-1(ET-1)、一氧化氮(NO)、尿白蛋白排泄率(UARE)等指标的变化，并进行两组临床疗效比较。结果：治疗组在降低TG、TC、LDL-C、Cr、UAER、Cys C、ET-1和升高HDL-C、GFR、NO方面优于对照组(P<0.05或P<0.01)。治疗组总有效率为93.33%，对照组为70.00%，两组比较差异有统计学意义(字2=10.909，P<0.01)。结论：替米沙坦联合阿魏酸钠可有效调节血脂水平，改善内皮功能，降低尿蛋白，对糖尿病肾病有保护作用，并能明显提高临床疗效，值得临床推广使用。%Objective:To investigate the clinical therapeutic efficacy of telmisartan combined with sodium ferulate in patients with type 2 diabetic nephropathy early(DN).Methods:120 DN patients were randomly divided into treatment group(n=60) and control group(n=60),and basal treatment was given to both groups.The treatment group was treated with telmisartan combined with sodium ferulate.Changes of blood lipid,plasma cystatin C(CysC) levels,endothelin-1(ET-1), nitric oxide(NO),and 24 h urinary albumin excretion rate(UAER),other metabolic parameters were observed,and the clinical effect of two groups were observed and compared after administration of the medicine for 4 weeks.Results:Compared with control group,TC,Cys C,LDL-C,ET-1 and UARE in treatment group were significantly decreased,but plasma NO,HDL-C,GFR levels were significantly increased (P<0.05 or P<0.01).The curative effects in the treatment group were significantly superior to those in control group(X2=10.909,P<0.01).Conclusion:Telmisartan combined with sodium ferulate has definite regulatory effect on the blood lipids in patients with DN,can improve endothelial function,decrease proteinuria,protect kindey,increase clinical therapeutic effect,is worth wide spread application.