替米沙坦联合沙格雷酯治疗老年糖尿病肾病的临床研究

Clinical study of telmisartan combined with sarpogrelate in the treatment of diabetic nephropathy in elderly patients

目的探究联合沙格雷酯治疗老年糖尿病肾病的临床疗效。方法选取2015年1月至2018年12月于我院接受治疗的145例老年糖尿病肾病病人为研究对象,按照随机数字表法将病人分为2组,对照组72例,接受常规糖尿病治疗(前列地尔静注10μg/d),观察组共73例,在对照组基础上接受替米沙坦联合沙格雷酯治疗。4周后,比较2组病人的空腹胰岛素、血糖、血压、血尿素氮、血清肌酐水平和尿白蛋白排泄率。结果与治疗前比较,治疗后2组空腹胰岛素、FPG、餐后2 h血糖水平差异均具有统计学意义(P<0.05);治疗后观察组胰岛素水平高于对照组,FPG、餐后2 h血糖水平低于对照组(P<0.05);与治疗前比较,治疗后2组血压、血尿素氮、血清肌酐水平、尿白蛋白排泄率均降低,观察组降低更显著(P<0.05)。结论替米沙坦联合沙格雷酯应用于老年糖尿病肾病的治疗,能够有效缓解病人的血糖异常情况,降低血压和尿白蛋白排泄率,促进肾功能的恢复,临床上值得推广。

Objective To explore the clinical efficacy of telmisartan combined with sarpogrelate in the treatment of diabetic nephropathy in the elderly patients.Methods A total of 145 elderly patients with diabetic nephropathy who were treated in our hospital from January 2015 to December 2018 were selected as the research subjects.All patients were divided into two groups according to the random number table method.Seventy-two patients in the control group received conventional diabetes treatment(alprostadil intravenously),and 73 cases in the observation group received telmisartan and sarpogrelate on the basis of the control group.After 4 weeks,the levels of fasting insulin and blood glucose,blood pressure,blood urea nitrogen,serum creatinine level and urine albumin excretion rate were compared between the two groups.Results Compared with those before treatment,the levels of fasting insulin,fasting plasma glucose(FPG),and 2 h postprandial plasma glucose(2hPG)in the two groups after treatment showed statistically significant difference(P<0.05);the level of insulin in the observation group after treatment was higher than that in the control group,and the levels of FPG and 2hPG were lower than those in the control group(P<0.05).Compared with those before treatment,the level of blood pressure,blood urea nitrogen,serum creatinine,and the excretion rate of urinary albumin in the two groups after treatment decreased significantly(P<0.05),especially in the observation group(P<0.05).Conclusions Telmisartan and sarpogrelate could be used in the treatment of senile diabetic nephropathy,which can effectively relieve the patients’abnormal blood glucose,reduce blood pressure and excretion rate of urinary albumin,and promote the recovery of renal function,which is worthy of clinical promotion.