司维拉姆联合依帕司他治疗糖尿病肾病的临床效果

Clinical efficacy of sevelamer combined with epalrestat in treatment of diabetic nephropathy

目的司维拉姆联合依帕司他治疗糖尿病肾病的临床效果。方法选择2013年1月-2015年12月榆林市第二医院收治的83例糖尿病肾病患者,随机分为两组。两组均采取血液透析治疗,对照组口服依帕司他治疗,每次50 mg,每天3次;观察组在对照组基础上联合服用司维拉姆治疗。两组均治疗3个月。检测两组治疗前后的炎性指标、脂代谢指标、血钙和血磷,并进行2年的随访。结果观察组治疗后的肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、三酰甘油(TG)、甲状旁腺激素(iPTH)和血磷明显低于治疗前,同组治疗前后比较差异有统计学意义(P<0.05);对照组治疗前后的各临床检测指标相比均无明显的差异;观察组的冠状动脉钙化率明显低于对照组,差异有统计学意义(P<0.05)。两组的2年生存率以及心血管事件病死率相比均无明显的差异。结论司维拉姆联合依帕司他可以有效抑制糖尿病肾病患者的炎症反应,调节血脂水平,改善血管钙化情况,降低冠状动脉钙化发生率,有助于改善患者的预后。

Objective To study the clinical efficacy of sevelamer combined with epalrestat in the treatment of diabetic nephropathy.Methods Selected 83 cases of patients with diabetic nephropathy who were treated in our hospital from January 2013 to December2015, divided into two groups randomly. The two groups were treated with hemodialysis, the control group was treated with oral epalrestat and the observation group was combined with sevelamer. Results After treatment, TNF-α, IL-6, LDL-C, CRP, TC, TG,iPTH and blood phosphorus were significantly lower than those before treatment(P < 0.05), and there was no significant difference in the clinical test indexes before and after treatment in the control group. The rate of coronary artery calcification in the observation group was significantly lower than that of the control group(P < 0.05). There was no significant difference in the 2 year survival rate between the two groups and the mortality of the cardiovascular events. Conclusion Sevelamer combined with epalrestat can effectively inhibit the inflammatory response in patients with diabetic nephropathy, regulate blood lipid levels, improve vascular calcification, reduce the incidence of coronary artery calcification, and help to improve the prognosis.