贝那普利联合帕立骨化醇对糖尿病肾病患者尿微量蛋白、尿白蛋白排泄率水平的影响

Effect of benazepril combined with paricalcitol on urinary microprotein and urinary albumin excretion rate in patients with diabetic nephropathy

目的 探讨贝那普利联合帕立骨化醇对糖尿病肾病患者尿微量蛋白、尿白蛋白排泄率水平的影响。方法 回顾性分析2020年1月至2021年8月于台州市中心医院就诊的糖尿病肾病患者126例,根据治疗方案不同分为贝那普利组和联合组,每组各63例。贝那普利组予以单纯贝那普利片治疗,联合组在贝那普利组基础上辅以帕立骨化醇注射液联合治疗,两组均治疗3个月。采用BK-280全自动生化分析仪对肾小球滤过率(epidermal growth factor receptor,e GFR)、尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,Scr)、β2微球蛋白(β2-microglobulin,β2-MG)水平进行检测;采用放射免疫法检测尿微量蛋白、尿白蛋白水平;采用酶联免疫吸附法对低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、极低密度脂蛋白胆固醇(very low-density lipoprotein cholesterol,VLDL-C)、果糖胺水平进行检测,比较两组的临床疗效并观察不良反应。结果 治疗后,两组患者eGFR、HDL-C水平升高,BUN、Scr、β2-MG、尿微量蛋白、尿白蛋白、LDL-C、VLDL-C、果糖胺水平降低;相比贝那普利组,联合组e GFR、HDL-C水平较高,BUN、Scr、β2-MG、尿微量蛋白、尿白蛋白、LDL-C、VLDL-C、果糖胺水平较低,差异均有统计学意义(P<0.05)。联合组的治疗有效率高于贝那普利组,差异有统计学意义(P<0.05)。结论 贝那普利联合帕立骨化醇可有效提高糖尿病肾病的治疗效果,降低患者的尿微量蛋白、尿白蛋白排泄率水平,改善患者的肾功能,效果显著。

Objective To investigate the effect of benazepril combined with paricalcitol on urinary microprotein and urinary albumin excretion rate in diabetic nephropathy patients.Methods A retrospective study was performed on 126 patients with diabetic nephropathy in Taizhou Central Hospital from January 2020 to August 2021.According to different treatment regimens,they were divided into benazepril group and combined group,which were treated with single benazepril tablet and combined treatment with parietalcide injection for 3 months.Epidermal growth factor receptor(eGFR),blood urea nitrogen(BUN),serum creatinine(Scr)were detected by USING BK-280 automatic biochemical analyzer.The levels of Scr andβ2-microglobulin(β2-MG)were detected.The levels of urinary microprotein and urinary albumin were detected by radioimmunoassay,and the levels of low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),very low-density lipoprotein cholesterol(VLDL-C)and fructosamine levels were detected,clinical efficacy was counted,and adverse reactions were observed.Results After treatment,the levels of eGFR and HDL-C increased,while BUN,Scr,β2-MG,urinary microprotein,urinary albumin,LDL-C,VLDL-C and fructosamine decreased.Compared with benazepril group,the levels of eGFR and HDL-C in combined group were higher, and the levels of BUN, Scr, β2-MG, urinary microprotein, urinary albumin, LDL-C, VLDL-C and fructosamine were lower, the differences were statistically significant (P<0.05). The effective rate in combination group was higher than that in benazepril group, the difference was statistically significant (P<0.05). Conclusion Benazepril combined with paricalcitol can effectively improve the therapeutic effect of diabetic nephropathy, reduce the urinary microprotein and urinary albumin excretion rate of patients, improve the renal function of patients, the effect is significant.