吡格列酮联合替米沙坦治疗Ⅲ～Ⅳ期糖尿病肾病的临床疗效分析

Pioglitazone and telmisartan in treatment of stage Ⅲ- Ⅳ of diabetic nephropathy

目的观察吡格列酮联合替米沙坦对Ⅲ～Ⅳ期糖尿病肾病的临床疗效。方法63例患者随机分成3组：吡格列酮组（n=19）、替米沙坦组（n=22）和联合治疗组（n=22），随访时间均为3个月；观察3组治疗前后空腹血糖（FBG）、餐后2h血糖（2hBG）、糖化血红蛋白（HbA1c）、24h尿蛋白、肾功能、肝功能和血钾（K^＋）等变化。结果3组24h尿蛋白于治疗后均有显著下降（P〈0．05），联合用药组治疗后下降更为明显（P〈0．01）。结论吡格列酮和替米沙坦在糖尿病肾病中均能减少尿蛋白，且联合用药疗效优于单一用药。

Objective To observe the clinical effects of pioglitazone and telmisartan on the stage Ⅲ - Ⅳ of diabetic nephropathy. Methods In this study,63 cases of diabetic nephropathy were randomly divided into 3 groups ： pioglitazone group （ n = 19）, telmisartan group （ n = 22） and combination group（ n =22）. The median follow -up duration was 3 months. Levels of FBG,2 hBG,HbAlc ,24 h urinary protein and SCr were compared before and after treatment. Results 24h urinary protein were decreased in three groups after treatment （ p 〈 0.05 ）, but descent of 24h urinary protein in combination group was better than the others （ P 〈 0.01 ）. Conclusions Pioglitazone and telmisartan can both reduce the excretion rate of urinary protein, and the combination use is better than the single use of them.