羟苯磺酸钙联合贝那普利治疗早期糖尿病肾病的疗效与安全性

Effect and safety of dobesilate and benazepril combination on the therapy for early diabetic nephropathy

目的评价羟苯磺酸钙和贝那普利联合治疗早期糖尿病肾病(DN)的疗效与安全性。方法入选DN患者102例,随机分为A、B、C 3组,3组控制血糖方法相同。A组34例口服羟苯磺酸钙1000 mg tid,B组33例口服贝那普利10 mg·d-1,C组35例口服羟苯磺酸钙1000 mg tid并联合贝那普利10 mg·d-1,均治疗12周,比较治疗前后3组平均动脉压(MAP)、糖化血红蛋白(HbA1c)、血肌酐(Scr)、肌酐清除率(Ccr)、纤维蛋白原(FIB)及尿白蛋白排泄率(UAER)的变化。结果 3组患者治疗前后MAP、HbA1c、Scr、Ccr水平无明显变化(P>0.05);A和C组治疗后FIB较治疗前显著下降(P<0.05);3组患者治疗后UAER均有不同程度下降,C组下降更为显著(P<0.05)。C组有1例皮肤过敏。结论羟苯磺酸钙和贝那普利联合治疗早期DN能有效降低UAER,且能降低FIB,能有效逆转或延缓早期DN进展,且药物不良反应少。

Objective To observe the effects and safety of dobesilate and benazepril combination therapy on early diabetic nephropathy （ DN）.Methods One hundred and two cases of early DN patients were randomly divided into A, B, and C groups, and the same glyce-mic control method were adopted in three groups.Group A （ 34 pa-tients） were treated with dobesilate of 1000 mg 3 times a day orally, group B （ 33 patients） were treated with benazepril 10 mg a day oral-ly, and 35 patients in group C were treated with dobesilate of 1000 mg 3 times a day combined with enalapril 10 mg one day orally.Three groups were treated for l2 weeks.The changes of three groups before and after treatment in the mean arterial pressure （ MAP） , glycated he-moglobin （ HbA1 c ） , serum creatinine （ Scr ） , creatinine clearance rate （ Ccr ） , fibrinogen （ FIB ） and urinary albumin excretion rate （ UAER） were compared.Results Compared with pre-treatment, MAP, HbA1 c, Scr, Ccr levels of the three groups had no significant differences （ P〉0.05 ） .FIB level of group A and C decreased signifi-cantly （ P 〈0.05 ） .UAER of three groups were decreased , and the group C decreased more significantly （ P〈0.05 ）.There was one case of skin allergies in group C.Conclusion Dobesilate and benazeprilcombination treatment for early diabetic nephropathy can effectively reduce UAER and FIB , reverse or slow the progress of early DN, with less adverse reactions.