那格列奈联合卡托普利治疗糖尿病肾病的临床研究

Therapeutic Effect of Nateglinide Combined with Captopril for Treatment of Diabetic Nephropathy

目的探讨那格列奈联合卡托普利治疗2型糖尿病肾病患者的临床疗效。方法 92例糖尿病肾病(Mogensen分期Ⅲ-Ⅳ期)患者,随机分为2组,试验组47例,那格列奈加卡托普利联合治疗;对照组45例,那格列奈治疗每日3次。疗程均为6周,观察治疗前后两组患者空腹血糖(FBG)、餐后2h血糖(2hBG)、糖化血红蛋白(HbA1c)、24h尿蛋白定量、血尿素氮(BUN)、肌酐(SCr)及血压的变化。结果对照组FBG、2hBG、HbA1c、24h尿蛋白定量均有下降,与治疗前比较差异有统计学意义(P<0.05),而BUN、SCr和血压与治疗前比较无明显变化;实验组在FBG、2hBG、HbA1c、24h尿蛋白定量、BUN、SCr和血压等方面均有下降,较治疗前有明显差异(P<0.05);治疗后,实验组在24h尿蛋白定量、BUN、SCr和血压4个指标优于对照组,差异有统计学意义(P<0.05)。结论那格列奈联合卡托普利治疗糖尿病肾病可有效控制血糖,改善肾脏功能。

Objective To evaluate the efficacy of nateglinide combined with captopril in patients with diabetic nephropathy.Methods Totally 92 patients with diabetic nephropathy（by Mogensen＇s stages：Ⅲ-Ⅳ）were randomly divided into 2 groups,47 patients in the trial group were treated by nateglinide combined with captopril injection.The other 45 patients in the control group were treated by nateglinide injection thrice daily.Both groups were under treatment for six weeks as a course,and the values of fasting blood glucose（FBG）,postprandial 2h plasma glucose（2hBG）,glycosylated hemoglobin（HbA1c）,24h urinary protein,blood urea nitrogen（BUN）,creatinine（SCr）and blood pressure before and after the treatment were observed.Results In control group FBG,2hBG,HbA1c,24h urine protein were decreased compared with that before treatment was significantly（P0.05）,while BUN,SCr,and blood pressure showed no change;the experimental group in FBG,2hBG,HbA1c,24h urinary protein,BUN,SCr and blood pressure have declined significantly different than those before treatment（P0.05）;after treatment,24h urine protein,BUN,SCr and blood pressure of the trial group were better than the control group,the difference was statistically significant（P0.05）.Conclusion Nateglinide combined with captopril in treatment of diabetic nephropathy can effectively control blood sugar,improve kidney function.