CAVI评估丹红注射液联合脑心通胶囊对高龄糖尿病肾病早期病变患者血管僵硬度的影响

Influence of Danhong Injection combining Naoxintong Capsule on vascular stiffness in elderly patients with early lesions of diabetic nephropathy:reviewed by cardio-ankle vascular index

目的 通过无创血管动脉硬化诊断系统检测高龄糖尿病肾病早期患者心脏-脚踝血管指数（CAVI）,评估糖尿病肾病血管僵硬度,同时评估丹红注射液联合脑心通胶囊对血管僵硬度的改善情况。方法 选取2013年2月-2015年12月于陆军总医院住院治疗的75岁以上糖尿病肾病早期病变患者90例,男性85例,女性5例。将其随机分为观察组（45例）和对照组（45例）。针对患者原发病给予严格的血糖控制。对照组在控制血糖治疗的基础上给予培哚普利;观察组在对照组基础上加用丹红注射液静脉滴注,同时给予脑心通胶囊。持续治疗2周后停丹红注射液,继续脑心通胶囊药物治疗6个月。记录患者治疗期间的不良反应。治疗前及治疗6个月后检测24 h的尿蛋白定量、CAVI变化。同时评价疗效。结果两组治疗后24 h尿蛋白定量改善情况,观察组显效8例、有效30例、无效7例,总有效率为84.44%;对照组显效6例、有效19例、无效20例,总有效率为55.56%。观察组总有效率明显高于对照组（84.44%vs.55.56%）,差异具有统计学意义（P〈0.05）。两组患者治疗后24 h尿蛋白定量和CAVI值均较治疗前有所下降,差异有统计学意义（P均〈0.05）。与对照组治疗后比较,观察组24 h尿蛋白定量和CAVI值明显下降,[（0.45±0.07）g vs.（0.22±0.06）g],[（8.71±0.79）vs.（7.88±0.93）],差异有统计学意义（P均〈0.05）。两组患者不良反应发生率比较,差异无统计学意义（P〉0.05）。结论 高龄糖尿病肾病早期病变患者的血管僵硬度升高,经丹红注射液联合脑心通胶囊治疗后血管僵硬度改善,治疗有效率明显提高。心脏-脚踝血管指数检测可作为评估高龄糖尿病肾病患者血管状态的经济实用指标。

Objective To detect cardio-ankle vascular index（CAVI） by using noninvasive vascular arteriosclerosis diagnosis system for reviewing vascular stiffness and effect of Danhong Injection combining Naoxintong Capsule on vascular stiffness in elderly patients with early lesions of diabetic nephropathy（DN）. Methods The elderly patients with DN（aged over 75, n=90, male 85 and female 5） were chosen from the Chinese PLA Army General Hospital from Feb. 2013 to Dec. 2015, and randomly divided into observation group and control group（each n=45）. All patients were given strict blood sugar control aiming at primary disease, and control group was given perindopril based on controlling blood sugar and observation group was additionally given intravenous drip of Danhong Injection and Naoxintong Capsule orally. The treatment was kept for 2 w, and then Naoxintong Capsule was continuously given for 6 m. The adverse reactions were recorded in all patients. The changes of 24 h urine protein（UP） quantitation and CAVI were detected before and 6 m after treatment, and curative effect was reviewed. Results The results of 24 h UP quantitation detection showed that there were 8 with remarkable curative effects, 30 with curative effects and 7 without curative effect, and the total effective rate was 84.44% in observation group, and there were 6 with remarkable curative effects, 19 with curative effects and 20 without curative effect, and the total effective rate was 55.56%（P〈0.05）. The quantitation of 24 h UP and CAVI decreased in 2 groups after treatment（all P〈0.05）. After treatment, the quantitation of 24 h UP and CAVI decreased significantly in observation group compared with control group [（0.45±0.07） g vs.（0.22±0.06） g],[（8.71±0.79） vs.（7.88±0.93）, all P〈0.05]. The comparison in incidence of adverse reaction had no statistical significance between 2 groups（P〈0.05）. Conclusion The vascular stiffness increases in elderly patients with early lesions of DN, which is relieved after treatment with Danhong Injection combining Naoxintong Capsule and effective rate is improved. The detection of CAVI can be taken as an economical and practical index for reviewing vascular conditions in elderly patients with early lesions of DN.