大剂量缬沙坦对糖尿病肾病患者尿蛋白排泄量和肾功能的影响

Effect of large valsartan dose on urinary protein excretion and renal function in diabetic nephropathy patients

目的对大剂量缬沙坦在治疗糖尿病肾病中对患者尿蛋白排泄量和肾功能的影响进行评价。方法选取2011-2012年我院收治的60例糖尿病肾病患者作为研究对象,在糖尿病治疗措施的基础上,加用口服大剂量缬沙坦(162 mg/d),对治疗前、后患者的血压、24 h尿蛋白、24 h尿清蛋白、24 h尿β2微球蛋白、24 h尿IgG、血尿素氮、血肌酐、血β2微球蛋白、血钾、空腹血糖进行观察。结果患者24 h尿总蛋白、24 h尿清蛋白、24 h尿β2微球蛋白和24 h尿IgG与治疗前相比均显著降低(P<0.05),收缩压、舒张压与治疗前相比也显著降低(P<0.05);血β2微球蛋白、血尿素氮、血肌酐、血钾及空腹血糖与治疗前差异均无统计学意义(P>0.05)。结论应用大剂量缬沙坦治疗糖尿病肾病,可明显改善患者的蛋白尿症状和血压,对患者的肾脏有保护作用。

Objective To assess the effect of large valsartan dose on urinary protein excretion and renal function in diabetic nephropathy patients. Methods The blood pressure, 24 h urinary protein, 24 h urinary albumin, 24 h urinary β2 microglobulin, 24 h urinary IgG, serum levels of urea nitrogen, creatinine, β2 microglobulin, potassium, and fasting blood glucose were measured in 60 diabetic nephropathy patients admitted to our hospital from 2011 to 2012 before and after they received combined antidiabetic and large oral valsartan treatment. Results The 24 h urinary protein, 24 h urinary albumin, 24 h urinary β2 microglobulin, 24 h urinary IgG, systolic and diastolic blood pressure were significantly lower in the patients after treatment than before treatment （P 〈 0.05）. However, no significant difference was found in serum levels of β2 microglobulin, urea nitrogen, creatinine, potassium and fasting blood glucose before and after treatment （P 〉 0.05）. Conclusion Large valsartan dose can protect the kidneys of diabetic nephropathy patients by improving their proteinuria and blood pressure.