醛固酮受体拮抗剂治疗糖尿病肾病的可行性研究和临床应用价值

Feasibility Study and Clinical Application Value of Aldosterone Receptor Antagonist in the Treatment of Diabetic Nephropathy

目的探讨固酮受体拮抗剂治疗糖尿病肾病的可行性研究和临床应用。方法选取该院2018年5月—2019年7月就诊的76例DN患者,经随机分为对照组与实验组,各38例。对照组服用厄贝沙坦,实验组加用螺内酯片,均治疗3个月,观察以肌酐清除率、24 h尿微量蛋白、肌酐、血钾、临床疗效为观察指标。Ccr、24 h尿微量蛋白,于治疗前后采集尿液标本进行检测;Cr、血钾,治疗前后采集空腹血液标本进行检测对比。结果治疗前两组Ccr、24 h尿微量蛋白、Cr、血钾差异无统计学意义(P>0.05);治疗后,实验组Ccr指标高于对照组(P<0.05),且24 h尿微量蛋白、Cr、血钾指标低于对照组(P<0.05)。治疗结束后,实验组总有效率(94.74%)高于对照组(76.32%)(P<0.05)。结论醛固酮受体拮抗剂应用在治疗DN时具有一定的可行性,且临床应用价值明显。

Objective To investigate the feasibility and clinical application of steroid receptor antagonists in the treatment of diabetic nephropathy.Methods A total of 76 patients with DN who were treated in the hospital from May 2018 to July 2019 were randomly divided into control group and experimental group,each with 38 cases.The control group was treated with irbesartan,and the experimental group was treated with spironolactone tablets for three months.The creatinine clearance rate,24h urine microprotein,creatinine,serum potassium,and clinical efficacy were observed.Ccr,24h urine microprotein,urine samples were collected before and after treatment for testing;Cr,potassium,fasting blood samples were collected before and after treatment for detection and comparison.Results There were no statistically significant differences in Ccr,24-hour urine microprotein,Cr,and potassium in the two groups before treatment(P>0.05).After treatment,the Ccr index in the experimental group was higher than that in the control group(<0.05).The serum potassium index was lower than the control group(P<0.05).After treatment,the total effective rate in the experimental group(94.74%)was higher than that in the control group(76.32%)(P<0.05).Conclusion The application of aldosterone receptor antagonists is feasible in the treatment of DN,and its clinical application value is obvious.