活性维生素D联合ARB对早期糖尿病肾病微量白蛋白尿疗效观察

Efficacy Observation of Active Vitamin D Combined with ARB on Microalbuminuria in Early Diabetic Nephropathy

目的:观察活性维生素D联合ARB对早期糖尿病肾病微量白蛋白尿的疗效。方法:选取2011-2013年在本院就诊的45例符合早期糖尿病肾病诊断标准的患者,按照随机数字表法将其分为ARB治疗组(A组)、活性维生素D治疗组(B组)、ARB联合活性维生素D治疗组(C组)各15例,各组患者均给予常规糖尿病治疗。疗程16周,观察比较各组治疗前后尿微量白蛋白(U-mAlb)、血TGF-β1指标的变化。结果:治疗16周后,各组尿微量白蛋白、血TGF-β1水平均明显低于治疗前,差异均有统计学意义(P<0.05),其中联合治疗组尿微量白蛋白、血TGF-β1水平下降最明显(P<0.05)。结论:活性维生素D可以减少早期糖尿病肾病尿微量白蛋白,减轻肾脏纤维化,且联合ARB治疗后疗效更为显著,值得临床推广。

To observe the efficacy of active vitamin D combined ARB on microalbuminuria in early diabetic nephropathy.Method：45 patients in accordance with the standard for early diagnosis of diabetic nephropathy in our hospital from 2011 to 2013 were selected,they were randomly divided into the ARB treatment group（the group A）, active vitamin D treatment group（the group B）,ARB combined active vitamin D treatment group（the group C）,15 cases in each group.All patients were given conventional diabetes treatment for 16 weeks.The changes of urine albumin （U-mAlb）,serum TGF-β1 before and after treatment in each group were observed and compared.Result：After 16 weeks,urinary albumin and serum TGF-β1 levels of three groups were significantly lower than before treatment,the differences were statistically significant（P〈0.05）,the urinary albumin and serum levels of TGF-β1 in the combined treatment group decreased significantly（P〈0.05）.Conclusion：The active vitamin D can reduce microalbuminuria in early diabetic nephropathy and kidney fibrosis,the therapy is more significant when combined with ARB,is worthy of clinical promotion.