羟苯磺酸钙和缬沙坦联合治疗对老年早期糖尿病肾病患者ET和CysC的影响

Effect of calcium dobesilate combined with valsartan treatment on the level of endothelin and cystatin-C in the elderly patients with early diabetic nephropathy

目的观察缬沙坦和羟苯磺酸钙联合治疗对老年早期糖尿病肾病(DN)患者内皮素(ET)和血清胱抑素C(CysC)的影响。方法选择老年2型糖尿病早期肾病患者76例均分为4组,每组19例。对照组:给予常规治疗;羟苯磺酸钙(安多明)组:安多明0.25 g,bid,po;缬沙坦(代文)组:代文80 mg,qd,po;羟苯磺酸钙+缬沙坦组(联合组):安多明0.25 g,bid,po+代文80 mg,qd,po。观察治疗前、治疗1个月及6个月后各组患者ET和胱抑素C的水平变化。结果羟苯磺酸钙组:治疗后Fib水平较治疗前明显下降(P<0.05);缬沙坦组:治疗后血压水平明显下降(P<0.01);联合组:治疗后血压及Fib水平均明显下降(P<0.01及P<0.05)。治疗1个月后,三组治疗组ET和胱抑素C水平较治疗前明显下降(P<0.05),三组治疗组与对照组比较,上述指标差异有统计学意义(P<0.05);治疗6个月后,三组治疗组ET和胱抑素C水平较治疗前水平进一步下降(P<0.01),与对照组比较,差异有统计学意义(P<0.01)。结论羟苯磺酸钙和缬沙坦联合治疗,可以降低老年早期糖尿病肾病患者ET和血清胱抑素C的水平。联合用药的效果明显优于药物单用的疗效。

Objective To explore the effect of calcium dobesilate combined with valsartan treatment on the level of endothelin and cystatin-C in the elderly patients with early diabetic nephropathy. Methods 76 cases of elderly patients with early diabetic nephropathy were divided into four groups,19 cases in each group,control group was given conventional treatment. Calcium dobesilate group was given calcium dobesilate,0. 25 g,bid,po. Valsartan group was given valsartan 80mg,qd,po. Calcium dobesilate plus alsartan group was given calcium dobesilate,0. 25 g,bid,po and valsartan 80 mg,qd,po. The level of endothelin and cystatin-C were detected before treatment and one month,six months after the treatment.Results Calcium dobesilate group： the level of Fib decreased obviously compared with before treatment（ P〈0. 05）. Valsartan group： the level of blood pressure decreased obviously after treatment. Calcium dobesilate plus alsartan group： the level of blood pressure and Fib decreased obviously after treatment（ P 〈0. 01 or P〈0. 05）. Compared with before treatment,the level of endothelin and cystatin-C of the three treatment groups markedly decreased after one month treatment and there was significant difference compared with control group（ P〈0. 05）; Compared with before treatment,the level of endothelin and cystatin-C of the three treatment groups markedly decreased after six months treatment and there was significant difference compared with control group（ P〈0. 01）. The level of urinary albumin excretion rate and endothelin and cystatin-C were markedly decreased after six months treatment of calcium dobesilate（ P〈0. 01） and valsartan and cotreatment（ P〈0. 01）. Conclusion Calcium dobesilate plus valsartan can decrease the level of endothelin and cystatin-C of early diabetic nephropathy patients,the effect of co-treatment is better than that of single drug treatment.