福辛普利联合螺内酯治疗Ⅱ型糖尿病肾病患者蛋白尿的临床效果

Clinical effects of Fosinopril combined with Spironolactone in treatment of proteinuria in patients with type 2 diabetic nephropathy

目的:观察福辛普利联合螺内酯治疗Ⅱ型糖尿病肾病患者蛋白尿的临床效果。方法:选择Ⅱ型糖尿病肾病患者60例,采用随机数字表法将其分为观察组和对照组各30例,观察组患者采用福辛普利联合螺内酯治疗;对照组患者仅给予福辛普利治疗,疗程均为12周。比较两组患者血钾、白蛋白(ALB)、空腹血糖(FBG)、24 h尿蛋白定量(UAE)、血肌酐(Scr)、尿肌酐(Ucr)、糖化血红蛋白水平(HbA1c)和血压,并计算肾小球滤过率(GFR)。结果:治疗后,两组患者ALB水平升高,UAE下降,差异有统计学意义(P<0.05),且观察组较对照组变化明显(P<0.05);两组BMI、FBG、HbA1c水平及GFR、收缩压、舒张压略有下降,组间差异不明显(P>0.05)。结论:福辛普利联合螺内酯治疗Ⅱ型糖尿病肾病患者蛋白尿的临床效果优于单纯福辛普利治疗效果。

Objective: To investigate clinical effects of Fosinopril combined with Spironolactone in treatment of proteinuria in patients with type 2 diabetic nephropathy. Methods: Sixty patients with type 2 diabetic nephropathy were selected and divided into observation group( n = 30) and control group( n = 30) according to the random number table. Fosinopril combined with Spironolactone were used in the observation group,while only Fosinopril was given in the control group. The treatment lasted for 12 weeks. The levels of serum potassium,albumin,fasting blood glucose( FBG),urinary protein( UAE),serum creatinine( Scr),urinary creatinine( Ucr),HbA1 c and blood pressure were measured,and the glomerular filtration rate( GFR) was calculated. Results: After the treatment,the levels of ALB increased and UAE decreased in both groups,and the differences were statistically significant( P<0.05). The levels of BMI,FBG,HbA1 c,GFR,systolic blood pressure,and diastolic blood pressure of the two groups decreased slightly,but the differences were not significant between the two groups( P>0.05). Conclusions: For the treatment of proteinuria in the type 2 diabetic nephropathy patients,Fosinopril combined with Spironolactone is more effective than single Fosinopril.