银杏达莫注射液联合替米沙坦治疗早期糖尿病肾病的疗效

Efficacy of Ginkgo Leaf Extract and Dipyridamole Injection combined with telmisartan for early diabetic nephropathy

目的探讨替米沙坦联合银杏达莫注射液治疗早期糖尿病肾病(DN)的临床疗效。方法选取125例早期DN患者,随机分为替米沙坦组57例和联合组68例。两组患者均控制饮食和采用运动疗法,在此基础上替米沙坦组口服替米沙坦,联合组口服替米沙坦并静脉滴注银杏达莫注射液。治疗前后比较两组肾功能指标、血压、晚期氧化蛋白产物(AOPP)、高血压四项及氧化应激指标。结果治疗后,两组估计肾小球滤过率、尿白蛋白排泄率、收缩压和舒张压均较治疗前降低(均P <0. 05),且联合组尿白蛋白排泄率低于替米沙坦组(P <0. 05)。治疗后,两组血管紧张素Ⅱ和醛固酮水平均较治疗前下降(均P <0. 05)。治疗后,联合组超氧化物歧化酶水平较治疗前升高且高于替米沙坦组,而AOPP和丙二醛水平均较治疗前降低且低于替米沙坦组(均P <0. 05)。结论替米沙坦联合银杏达莫注射液不仅可以降低肾小球囊内压、抑制肾素-血管紧张素-醛固酮系统激活,还可减轻氧化应激反应,从而降低尿蛋白,延缓DN的发展。

Objective To explore the clinical efficacy of telmisartan combined with Ginkgo Leaf Extract and Dipyridamole Injection for early diabetic nephropathy(DN).Methods A total of 125 patients with early DN were randomly divided into telmisartan group(n=57)and combination group(n=68).On the basis of diet control and exercise therapy performed in both groups,the telmisartan group was given oral telmisartan,while the combination group was given oral telmisartan and intravenous drip of Ginkgo Leaf Extract and Dipyridamole Injection.The renal function indicators,blood pressure,advanced oxidative protein products(AOPP),hypertension indicators,and oxidative stress parameters were compared between the two groups before and after treatment.Results After treatment,the estimated glomerular filtration rate,urinary albumin excretion rate,systolic blood pressure and diastolic blood pressure decreased in both groups compared with those before treatment(all P<0.05),the urinary albumin excretion rate in the combination group was lower than that in the telmisartan group(P<0.05).After treatment,the levels of angiotensinⅡand aldosterone decreased in both groups compared with those before treatment(all P<0.05).After treatment,the level of superoxide dismutase in the combination group was higher than the level before treatment and in the telmisartan group,while the levels of AOPP and malondialdehyde were lower than the levels before treatment and in the telmisartan group(all P<0.05).Conclusion Telmisartan combined with Ginkgo Leaf Extract and Dipyridamole Injection can not only reduce intraglomerular pressure and inhibit the activation of renin-angiotensin-aldosterone system,but also diminish oxidative stress response,thus decreasing urinary protein and delaying DN development.