羟苯磺酸钙联合缬沙坦对老年早期糖尿病肾病患者血清内皮素和胱抑素C的影响

Influence of calcium dobesilate combined with valsartan on serum endothelin and cystatin C level in elderly patients with early diabetic nephropathy

目的观察羟苯磺酸钙联合缬沙坦对老年早期糖尿病肾病(DN)患者血清内皮素(ET)和胱抑素C(Cys C)的影响。方法 100例老年早期DN患者随机分为羟苯磺酸钙组30例,缬沙坦组33例,联合组37例,分别给予羟苯磺酸钙、缬沙坦单药治疗和联合治疗12周。结果联合组有效率显著高于羟苯磺酸钙组与缬沙坦组(P<0.05);3组治疗后血肌酐(Scr)、尿素氮(BUN)、尿蛋白排泄量(UAE)和血清ET、Cys C水平均较治疗前显著降低(P<0.05或P<0.01),且联合组显著低于羟苯磺酸钙组和缬沙坦组(P<0.05)。结论羟苯磺酸钙和缬沙坦联合用药治疗老年早期DN疗效优于单药治疗,可更有效降低血清ET、Cys C水平,改善肾功能。

Objective To observe the influence of calcium dobesilate combined with valsar- tan on serum endothelin （ET） and cystatin C （CysC） level of elderly patients with early diabetic nephropathy （DN）. Methods A total of 100 elderly patients with early DN were divided into calci- um dobesilate group （ n = 30）, valsartan group （ n = 33） and combination group （ n = 37）. Calcium dobesilate and valsartan monotherapy were applied for the calcium dobesilate group and the valsartan group, while combination therapy was applied for the combination group for 12 weeks. Results The response rate in the combination group was significantly higher than that in the other two groups （P〈0.05）. The serum creatinine （Scr）, urea nitrogen （BUN）, urine albumin excretion （UAE）, ET and CysC levels decreased significantly after treatment in all the groups（ P 〈 0.05 or P 〈 0.01 ）, and levels of these indicators in the combination group were significantly lower than those in the other two groups （P 〈 0.05）. Conclusion Calcium dobesilate combined with valsartan show a better clinical efficacy than monotherapy, and it can more effectively reduce serum ET and CysC level and improve renal function of elderly patients with DN.