羟苯磺酸钙与贝那普利治疗糖尿病肾病蛋白尿的疗效比较

Comparison of curative effect of Calcium Dobesilate and Benazepril for diabetic nephropathy

目的探讨羟苯磺酸钙与贝那普利治疗糖尿病肾病蛋白尿的临床疗效。方法 2008年7月至2010年6月在我院住院的63例糖尿病肾病患者采用随机数字表法分为2组：羟苯磺酸钙治疗组35例,剂量1.5 g/d,分3次服,疗程2个月;贝那普利治疗组28例,剂量每天10~30 mg,疗程2个月。观察治疗前后患者血肌酐、尿素氮、24小时尿白蛋白排泄率（UAER）及出现的不良反应。结果两组治疗后24小时UAER与治疗前比较明显下降（P〈0.01）,但羟苯磺酸钙组血肌酐、尿素氮未见升高,未出现不良反应;而贝那普利组血肌酐、尿素氮有所升高（P〈0.05）,3例出现咳嗽,其中1例因不能耐受而停药,1例糖尿病肾病V期患者血肌酐升高31.5μmol/L。治疗前后24小时UAER两组间比较,差异均无统计学意义（P〉0.05）。结论羟苯磺酸钙与贝那普利对糖尿病肾病患者的尿白蛋白有同样的降低效果,无副作用,尤其对肾功能不全的患者较安全,不会因加重肾血流量的减少而加重氮质血症。

Objective To investigate the curative effect of Calcium Dobesilate and Benazepril for diabetic nephropathy.Methods From July 2008 to Jun 2010,63 patients with diabetic nephropathy in our hospital were randomly divided into two groups.The 35 cases in Calcium Dobesilate group were given Calcium Dobesilate 1.5 g tid for 2 months.The 28 cases in Benazepril group were given Benazepril of a day,10~30mg qid for 2 months.Serum creatinine,urea nitrogen,24-hour urinary albumin excretion rate（UAER） and adverse reactions before and after treatment were observed.Results In Calcium Dobesilate group,UAER decreased significantly 24 hours after treatment（P0.01）.Serum creatinine and urea nitrogen didn＇t increase,without any adverse reactions.In Benazepril group,UAER decreased significantly 24 hours after treatment（P0.01）,while serum creatinine and urea nitrogen increased significantly（P0.05）.Three patients had cough,of which one was discontinued because of intolerance.Serum creatinine of one patient with diabetic nephropathy elevated 31.5 μmol/L.Conclusion Calcium Dobesilate had the same effect as Benazepril for diabetic nephropathy patients with urinary albumin（P0.05） without any side effect,especially in patients with renal insufficiency,for no reduction of renal blood flow and aggravation of azotemia.