缬沙坦胶囊在2型糖尿病肾病早期中的应用效果研究

Study of valsartan capsules in early stage of type 2 diabetic nephropathy

目的探讨缬沙坦胶囊在2型糖尿病肾病早期中的应用效果。方法选择2011年1月—2012年12月治疗的2型糖尿病肾病早期患者80例,根据随机数字表法分为观察组和对照组各40例,两组均给予常规治疗,所有患者均需要保持良好的生活习惯和方式配合药物治疗以促进治疗效果;控制血糖:根据患者情况使用降糖药物,如胰岛素等;扩血管,改善微循环:前列地尔注射液10μg加入0.9%氯化钠注射液100 ml静脉滴注,1次/d;降血压:卡托普利25 mg口服,1次/d,或加硝苯地平控释片10 mg口服,1次/d;降血脂:辛伐他汀片10 mg口服,1次/晚;对症处理:伴水肿者加利尿剂。观察组在常规治疗的基础上加缬沙坦胶囊80 mg口服,1次/d。两组均治疗12周评价疗效,比较两组血钾、糖化血红蛋白、低密度脂蛋白胆固醇、24 h尿蛋白量及血压。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果总有效率观察组95.0%,对照组70.0%,比较差异有统计学意义(P<0.05)。治疗后观察组24 h尿蛋白量、收缩压、舒张压[(1.05±0.57)g、(121.47±7.53)、(78.73±7.36)mm Hg(1 mm Hg=0.133 kPa)]与对照组[(1.50±0.79)g、(133.63±8.89)、(87.84±8.04)mm Hg]比较差异均有统计学意义(均P<0.05)。结论对于早期2型糖尿病肾病患者,在常规治疗的基础上加用缬沙坦胶囊,可显著降低24 h尿蛋白量,起到保护肾脏作用。

Objective To investigate the renoprotective properties of valsartan capsules in the treatment of type 2 diabetic patients with nephropathy.Methods Eighty cases of early stage type 2 diabetic nephropathy treated from January 2011 to December 2012 were selected and divided into observation group （n=40） and control group （n=40） with the method of random number table.Both groups were given conventional treatment and all patients were required to maintain good living habits to improve therapeutic effects and to control blood glucose.Alprostadil injection 10 μg was added into 100 ml of 0.9% sodium chloride injection for intravenous drip,once a day to dilate blood vessels and improve mierocirculation.Captopril was given orally,25 mg,once per day,or combined with oral nifedipine controlled release tablets,lO mg,onee daily to lower blood pressure.Simvastatin tablets were given orally,10 mg, once at night to lower blood lipids.Symptomatic treatment was also applied.For observation group,additional valsartan capsules were given o- rally,80 mg,once daily.Both groups were evaluated for clinical efficacy after a 12-week treatment and compared for serum potassium, glycosylated hemoglobin, LDL-C,24-hour urine protein and blood pressure.T-test was used for measurement data, x2 test for count data,the result of P〈0.05 showed significant＇difference.Results The total effective rate was 95% in observation group,70% in control group,and there was significant difference between the two groups（P〈0.05）.After treatment,24-hour urinary protein,systolic pressure and diastolic pressure were （1.05 ± 0.57） g,（121.47 ± 7.53）and （78.73 ± 7.36）mm Hg（1 mm Hg=0.133 kPa） respectively in observa- tion group,and they were （1.50 ± 0.79） g,（133.63 ±8.89） and （87.84± 8.04）mm Hg respectively in control group,which showed no sig- nificant difference （P〈O.OS）.Conclusion Combined with conventional therapy,valsartan capsules can significantly reduce 24-hour urine protein in early type 2 diabetic nephropathy and exhibit renoprotective properties.