舒洛地特对糖尿病肾病患者尿蛋白的影响

The Effects of Sulodexide on Proteinuria in Patients with Diabetic Nephropathy

目的:观察舒洛地特对已应用ACEI/ARB类药物的2型糖尿病肾病患者尿蛋白的影响。方法:据尿白蛋白排泄率将92例2型糖尿病肾病患者分为微量白蛋白尿组和大量白蛋白尿组,患者在入组前至少服用一种ACEI或ARB类降压药6个月,入组后先接受10d舒洛地特注射剂60mg/d静脉滴注,再接受110d舒洛地特软胶囊100mg/d口服。用药前、用药4周、8周、12周及120d分别检测患者血压、空腹血糖、肝肾功能、凝血功能、24h尿蛋白定量等指标。结果:两组患者治疗12周后均出现尿蛋白显著降低(P<0.05);治疗120d后,微量白蛋白尿和大量白蛋白尿组患者24h尿蛋白分别下降(38.97±14.67)%和(41.32±18.24)%,两组间比较差异无统计学意义(P>0.05)。结论:对已应用ACEI/ARB的伴有微量白蛋白尿或大量白蛋白尿的2型DN患者,舒洛地特能有效降低其尿蛋白。

Objective ：To observe the effects of sulodexide on proteinuria in patients with diabetic nephropathy who have re- ceived ACEI/ARB therapy. Methods：92 cases of type 2 diabetic nephropathy patients, who had received at least one kind of ACEI/ ARB drug therapy for at least 6 months, were devided into two groups： the microalbuminuria group and the macroalbuminuria group. All the patients were given sulodexide 60 mg/d by intravenous infusion for 10 days, and then given sulodexide 100 mg/d by oral use for 110 days. The blood pressure, fasting blood glucose, liver and kidney function, blood coagulation and 24 - hour urinary protein were measured before and 4 weeks, 8 weeks, 12weeks and 120 days after the use of sulodexide. Results：The proteinuria of the two groups reduced significantly after the use of sulodexide for 12 weeks（ P 〈 0.05 ）. And 120 days later, the 24 - hour urinary protein of the mieroalhuminuria group and the macroalhuminuria group reduced （38.97 ± 14.67 ）% and （41.32 ± 18.24）% respectively. There were no significant difference between the two groups （P 〉 0.05 ）. Conclusion ：Sulodexide can effectively reduce urinary protein of type 2 DN patients with micrealbuminuria or macroalbuminuria who have received ACEI/ARB therapy.