替米沙坦治疗早期糖尿病肾病的效果观察

Effect observation of telmisartan in the treatment of early diabetic nephropathy

目的探讨替米沙坦治疗早期糖尿病肾病的效果。方法选取2011年5月~2014年5月在本院治疗的70例早期糖尿病肾病患者作为研究对象,随机分为治疗组及对照组,各35例。对照组给予常规治疗,治疗组在对照组的基础上给予替米沙坦治疗。比较两组治疗前后的血糖、平均动脉压（MAP）、24 h尿蛋白排泄率（UAER）、C反应蛋白（CRP）及白介素-6（IL-6）水平。结果两组治疗后的空腹血糖及餐后2 h血糖水平显著低于治疗前,差异有统计学意义（P〈0.05）。两组治疗后的MAP、UAER、CRP及IL-6水平显著低于治疗前,差异有统计学意义（P〈0.05）。治疗组治疗后的MAP、UAER、CRP及IL-6水平显著低于对照组治疗后,差异有统计学意义（P〈0.05）。CRP及IL-6水平与UAER呈正相关,空腹血糖及餐后2 h血糖水平与UAER无显著性相关。结论炎症反应参与糖尿病肾病的发展,替米沙坦可以降低早期糖尿病肾病患者的MAP,减少尿蛋白排出,降低炎症反应,能够防治早期糖尿病肾病。

Objective To explore the effect of telmisartan in the treatment of early diabetic nephropathy（DN）. Methods 70 cases of early DN patients from May 2011 to May 2014 in our hospital were selected and randomly divided into the treatment group and the control group,35 cases in each group.The control group was given conventional therapy,the treatment group was given telmisartan on the basis of the control group.The level of blood glucose,mean arterial pressure（MAP）,24 hours urinary albumin excretion rate（UAER）,C reactive protein（CRP） and interleukin-6（IL-6） in the two groups was compared before and after treatment. Results The level of fasting blood glucose and postprandial 2hours blood glucose after treatment in the two groups was lower than that before treatment,with significant difference（P〈0.05）.The level of MAP,UAER,CRP and IL-6 after treatment in the two groups was lower than that before treatment,with significant difference（P〈0.05）.The level of MAP,UAER,CRP and IL-6 in the treatment group after treatment was lower than that in the control group after treatment,with significant difference（P〈0.05）.The level of CRP and IL-6 were positive correlation with UAER,but the level of fasting blood glucose and postprandial 2 hours blood glucose were not significant correlation with UAER. Conclusion Inflammatory reaction involves in the develepment of DN.Telmisartan can reduce the MAP in patients with early diabetic nephropathy,urinary protein excretion,inflammation,which can prevent and treat early DN.