波立维联合ARB治疗糖尿病肾病的临床疗效及对患者尿蛋白影响

Clinical Efficacy of Plavix and ARB in the treatment of Diabetic Nephropathy and Its Effect on the Urine Protein

目的:探讨波立维联合及血管紧张素II受体拮抗剂(AngiotensinⅡreceptor blockers,ARB)治疗糖尿病肾病的临床疗效及对患者尿蛋白水平的影响。方法:选取我院近3年收治的116例糖尿病肾病患者,按照数字随机表法将其分为研究组和对照组,每组各58例。对照组在常规治疗基础上给予ARB治疗,研究组在对照组的基础上给予波立维联合ARB治疗,两组患者均连续治疗4周,检测和比较两组治疗前后血清肿瘤坏死因子-α(Tumor necrosis factor-alpha,TNF-α)、白细胞介素-6(Interleukine,IL-6)和转化生长因子-β1 (Transforming growth factor-beta1,TGF-β1)、肌酐(Serum creatinine,SCr)、尿微量蛋白(Urinary microalbumin,U-malb)、24 h尿白蛋白定量(Albumin,Alb)、24 h尿蛋白排泄率(Urinary albumin excretion rate,UAER)、血液流变学指标红细胞刚性指标(Erythrocyte deformation index,TK)、纤维蛋白原(Plasma viscosity,PF)、血浆黏度(Plasma viscosity,PV)的变化情况及治疗期间不良反应的发生情况。结果:治疗后,研究组血清TNF-α、IL-6、TGF-β1、U-malb、Alb、UAER、TK、PF和PV水平均明显低于对照组(P<0.05);两组不良反应发生率对比无统计学差异(P>0.05)。结论:波立维联合ARB治疗糖尿病肾病有利于减轻炎性反应,改善患者肾脏血流动力学和肾功能,且安全性高。

Objective: To investigate the clinical efficacy of Plavix and ARB(angiotensin II receptor antagonist) in the treatment of diabetic nephropathy and its effect on urine protein evels in patients. Methods: 116 patients with diabetic nephropathy admitted to our hospital in the past 3 years were divided into study group and control group according to the numerical random table method, 58 cases in each group. The control group was treated with ARB on the basis of conventional treatment, and the study group was given Polivi and ARB. The two groups were treated continuously for 4 weeks. The serum TNF-α(Tumor) was detected and compared before and after treatment. Necrosis factor-alpha, TNF-α), interleukin-6(IL-6) and transforming growth factor-beta1(TGF-β1), creatinine(SCr), urinary micro Protein(Urinary microalbumin, U-malb), 24 h urinary albumin quantitation(Albumin, Alb), 24 h urine protein excretion rate(UAER), blood rheology index Erythrocyte deformation index(TK), changes in fibrinogen(PF), plasma viscosity(PV) and the occurrence of adverse reactions during treatment. Results: After treatment, the levels of serum TNF-α, IL-6, TGF-β1, U-malb, Alb, UAER, TK, PF and PV in the study group were significantly lower than those in the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: Polivi combined with ARB in the treatment of diabetic nephropathy is beneficial to reduce inflammatory reactions, improve renal hemodynamics and renal function, and is safe.