螺内酯联合缬沙坦在早期糖尿病肾病治疗中的作用

Application of spironolactone combined with valsartan in the treatment of early diabetic nephropathy

目的研究螺内酯联合缬沙坦对早期糖尿病肾病患者肾功能的作用。方法将56例早期糖尿病肾病(尿清蛋白排泄率:30～<300mg/d)患者随机分为治疗组和对照组,每组各28例,对照组在糖尿病常规治疗的基础上给予缬沙坦口服;治疗组在对照组治疗的基础上加用螺内酯,疗程3个月。比较并分析两组患者治疗前后的24h尿微量清蛋白、血清肌酐水平。结果两组患者治疗前后24h尿微量清蛋白比较,差异有统计学意义(P<0.05);治疗后两组比较,治疗组24h尿微量清蛋白和血清肌酐水平明显降低,与对照组比较差异有统计学意义(P<0.05)。结论螺内酯联合缬沙坦更能减少早期糖尿病肾病患者的尿蛋白,保护糖尿病肾病患者的肾功能。

Objective To study the effect of spironolactone combined with valsartan on the renal function of the patients with early diabetic nephropathy.Methods Fifty-six patients with early diabetic nephropathy(urinary albumin excretion rate was 30-<300 mg/d) were randomly divided into treatment group and control group,with 28 cases in each group.Control group orally took valsartan on the basis of the conventional treatment of diabetes.Spironolactone was added to treatment group on the basis of the treatment of control group.Both groups were treated for 3 months.24 h urine albumin and serum creatinine level before and after the treatment were compared and analyzed between the two groups.Results 24 h urinary albumin before and after the treatment were significantly different between the two groups(P>0.05).24 h urine albumin and serum creatinine level in treatment group were significantly lower than control group after treatment,and the difference showed a statistical significance(P>0.05).Conclusion Spironolactone combined with valsartan can reduce urinary protein in patients with early diabetic nephropathy and protect renal function of the patients with diabetic nephropathy.