羟苯磺酸钙联合缬沙坦治疗早期糖尿病肾病的疗效及其对患者血清ET、CysC水平的影响

摘要

目的 探讨羟苯磺酸钙联合缬沙坦治疗早期糖尿病肾病(DN)的疗效及其对患者血清内皮素(ET)、胱抑素C(Cys-C)水平的影响.方法 选择中国人民解放军第一七四医院内分泌科2015年9月至2017年4月期间收治100例早期DN患者为研究对象,根据随机数表法分为对照组和观察组,每组50例.对照组采用缬沙坦治疗,观察组应用羟苯磺酸钙联合缬沙坦治疗,疗程均为3个月.比较两组患者治疗前后的尿白蛋白排泄率(UAER)、血肌酐(Scr)、尿素氮(BUN)及ET、CysC水平的变化.结果 治疗后,观察组患者的UAER为(113.52±30.66)mg/24 h,明显低于对照组的(154.35±32.12)mg/24 h,差异有统计学意义(P<0.05),而治疗前后两组患者的Scr、BUN比较差异均无统计学意义(P>0.05);观察组患者的血清ET、CysC水平分别为(75.43±16.43)pg/mL和(1.22±0.27)mg/L,明显低于对照组的(97.14±17.38)pg/mL和(1.52±0.31)mg/L,差异均有统计学意义(P<0.05).结论 羟苯磺酸钙联合缬沙坦治疗早期糖尿病肾病可进一步改善患者的血管内皮功能,减少UAER,保护患者的肾功能.%Objective To investigate the effect of calcium dobesilate combined with valsartan in the treatment of early diabetic nephropathy(DN)and its influence on serum endothelin(ET)and cystatin C(Cys-C)level.Methods A total of 100 early DN patients who were treated in the 174thHospital of Chinese People's Liberation Army from September 2015 to April 2017 were slected as the research objects.According to random number table,they were divided into control group and observation group,with 50 cases in each group.The control group was treated with valsartan,and the observa-tion group was given calcium dobesilate combined with valsartan treatment, with the course of treatment for 3 months. The changes of urinary albumin excretion rate(UAER),serum creatinine(Scr),blood urea nitrogen(BUN),and the ET, CysC levels were compared between the two groups before and after treatment.Results After treatment,the UAER in observation group was(113.52±30.66)mg/24 h,which was significantly lower than(154.35±32.12)mg/24 h in con-trol group(P<0.05).However,there was no significant difference in Scr,BUN between the two groups before and af-ter treatment(P>0.05).The levels of serum ET,CysC in the observation group was(75.43±16.43)pg/mL and(1.22± 0.27)mg/L,which was significantly lower than(97.14±17.38)pg/mL and(1.52±0.31)mg/L in control group(P<0.05). Conclusion Calcium dobesilate combined with valsartan can improve the vascular endothelial function,reduce UAER and protect the renal function in patients with early diabetic nephropathy.