厄贝沙坦联合丹参酮ⅡA磺酸钠治疗早期糖尿病肾病的临床研究

Clinical Observation on Treatment of Early Diabetic Nephropathy with Irbesartan and Sodium Tanshinone IIA Sulfonate

目的探讨厄贝沙坦联合丹参酮ⅡA磺酸钠对早期糖尿病肾病(DN)的治疗效果。方法将72例早期DN患者随机分为厄贝沙坦组(36例)和联合用药组(36例),均服用厄贝沙坦150mg/d,联合用药组加丹参酮ⅡA磺酸钠注射液60mg/d,疗程4周。观察治疗前后尿微量白蛋白排泄率(UAER)、血液流变学各项指标、C反应蛋白(CRP)及血糖、血脂变化情况。结果2组UAER均较治疗前减少(P<0.05或P<0.01),但联合用药组好于厄贝沙坦组(P<0.05)。联合用药组治疗后血液流变学各项指标及CRP均较治疗前降低(P<0.05),厄贝沙坦组变化差异无统计学意义(P>0.05)。2组治疗前后血糖、血脂无明显变化(P>0.05)。结论厄贝沙坦与丹参酮ⅡA磺酸钠联合治疗早期DN,能改善血液流变学,降低CRP,减少尿微量白蛋白排泄率,延缓肾损害的进程。

OBJECTIVE To investigate into the effect of irbesartan and sodium tanshinone ⅡA sulfonate in the treatment of early diabetic nephropathy （DN）. METHOD Seventy-two DN patients were randomly divided into an irbesartan group of 36 patients and a mixed drug group of another 36 patients. Both groups took irbesartan （150 mg/d） and the mixed drug group was also given injection of sodium tanshinone ⅡA sulfonate （60 mg/d）, for four weeks. RESULT In both groups, trace albumin excretion decreased （ P 〈 0.05 or P 〈 0.01）, but better results was obtained in the mixed drug group than in the irbesartan group （P 〈 0.05）. In the mixed drug group, all the indexes in blood rheology and C-reactive protein decreased （P 〈 0.05）. The changes found in the irbesartan group were not statistically significant （ P 〉 0.05）. No marked changed were found in both groups in blood sugar and blood lipid （ P 〉 0.05）. CONCLUSION The combined use of irbesartan and sodium tanshinone ⅡA sulfonate in the treatment of early DN can improve blood rheology, reduce C - reactive protein and trace albumin excretion, and prolong the process of kidney damage.