活性维生素D联合ACEI降低糖尿病肾病蛋白尿60例临床效果观察

Clinical observation of active vitamin D combined with ACEI on reducing proteinuria in the 60 patients with diabetic nephropathy

目的观察活性维生素D联合血管紧张素转换酶抑制剂(ACEI)对降低糖尿病肾病患者蛋白尿的疗效。方法选取60例符合糖尿病肾病诊断标准的患者,按照随机数字表法将其分为ACEI治疗组(ACEI组)、活性维生素D治疗组(VD组)、ACEI联合活性维生素D治疗组(ACEI+VD组),每组各20例。各组患者均给予常规糖尿病治疗,疗程6个月,观察比较各组治疗前后24 h尿微量白蛋白(U-mALB)、血肌酐、血尿素氮、C反应蛋白(CRP)以及血清钙离子浓度等指标。结果治疗6个月后,各组24 h尿微量蛋白水平以及CRP水平均明显低于治疗前,其中ACEI+VD组24 h尿微量蛋白水平以及CRP降低最显著(P<0.05)。结论活性维生素D可以减少早期糖尿病肾病尿蛋白水平,减轻机体炎症反应,且联合ACEI治疗后疗效更为显著,值得临床推广应用。

Objective To investigate the effect of vitamin D combining with ACEI on proteinuria of the patients with diabetic nephropathy.Methods A randomized control trial was carried out in diabetic nephropathy patients.Sixty patients who met the diagnostic criteria for diabetic nephropathy from December 2017 to December 2019 were divided into ACEI group、vitamin D group and combined group.Clinical data were collected that included urine microalbumin(U-mALB),serum creatinine,blood urea nitrogen,CRP and serum calcium ion concentration in the beginning and 6th month.Results After 6 months of treatment,the 24 hour urine microprotein and CRP decreased in the three groups,and the combined group changed more significantly(P<0.05).Conclusion Vitamin D combining with ACEI has better anti-proteinuria in patients with diabetic nephropathy.