氯沙坦与胰激肽原酶联合治疗早期糖尿病肾病疗效观察

Combination Therapy with Losartan and Kallidinogenase for Early Diabetic Nephropathy

目的:观察采用氯沙坦与胰激肽原酶联合治疗早期糖尿病肾病的疗效。方法:42例早期糖尿病患者血糖控制稳定后随机分为两组(各21例),对照组采用氯沙坦(50mg/d)治疗,治疗组采用氯沙坦(50mg/d)与胰激肽原酶(120u/d)联合治疗,疗程共12周。观察治疗12周后各组患者的平均动脉压(MAP)、尿白蛋白(Alb)、尿球蛋白(β2-MG)、尿糖蛋白(THP)、血清肌酐(Scr)和尿素氮(BUN)、血糖、血脂及血清胰岛素变化。结果:两组患者治疗前后血糖、血总胆固醇、血甘油三酯、血清胰岛素未见明显变化,两组患者治疗后MAP、血清Scr和BUN、尿白蛋白、尿球蛋白、尿糖蛋白显著下降(P<0.05),治疗组尿Alb、β2-MG、THP下降更为明显,治疗过程中未出现明显不良反应。结论:氯沙坦与胰激肽原酶联合治疗可显著改善早期糖尿病患者尿蛋白的排出,是治疗早期糖尿病肾病的有效方法。

Objective： To observe the effects of combined use of losartan and kallidinogenase on the treatment of early diabetic nephropathy. Methods：Forty-two patients with early diabetic nephropathy were randomly divided into two groups （There are twenty- one patients in each group） after controlling the steady levels of blood glucose. Patients in the control group received daily treatment with losartan（50 mg/d）, and patients in the experiment group received daily treatment with losartan（50 mg/d） and kallidinogenase（120 u/d）. After the twelve-week medication, the patients underwent examinations for changes in the mean arterial blood pressure（MAP）, urine albumin（ALB）, urine β2 microglobulin（β2 - MG）, urine glycoprotein（THP）, serum creatinine（SCr）, blood ruea nitrogen（BUN）, the levels of blood glucose and fat as well as insulin. Resuits： Loartan used alone or combined use of losartan and kallidinogenase significantly lowered MAP, Scr, BUN, Alb, β2 - MG, THP, and combined use of the two drugs produced the most obvious reduction of the parameters measured. However, No obvious changes of the levels of blood glucose and fat as well as insulin were observed after treatment. Conclusion：Combined use of losartan and kallidinogenase may decrease Alb,β2 - MG and THP to a greater extent than that of losartan alone. And combined use of losartan and kallidinogenase is a good therapy for early diabetic nephropathy.