阿托伐他汀联合依那普利治疗伴白蛋白尿糖尿病肾病的效果分析

Effect analysis of atorvastatin combined with enalapril in the treatment of diabetic nephropathy complicated with albuminuria

目的:探讨阿托伐他汀联合依那普利治疗伴白蛋白尿糖尿病肾病(DN)患者的临床效果。方法:选取伴白蛋白尿DN患者122例,按照随机数字表法分为研究组和对照组,每组各61例。两组均予以常规血糖控制,在此基础上对照组采用依那普利治疗,研究组采用阿托伐他汀联合依那普利治疗。比较两组治疗总有效率,肾功能指标中尿白蛋白排泄率(UAER)、24 h尿蛋白定量(24 h UPR)、尿微量白蛋白(MAU)、α1微球蛋白(α1-MG)、β2微球蛋白(β2-MG),血管内皮功能指标包括一氧化氮(NO)、内皮素(ET),血清胱抑素C(CysC)、同型半胱氨酸(Hcy)水平及不良反应发生率。结果:研究组治疗总有效率93.44%高于对照组75.41%,差异有统计学意义(P<0.05);治疗后,两组UAER、24 h UPR、MAU、α1-MG、β2-MG均降低,且研究组低于对照组(P<0.05);两组NO水平升高,ET、CysC、Hcy水平降低,且研究组均优于对照组(P<0.05);两组不良反应总发生率比较差异无统计学意义(P>0.05)。结论:阿托伐他汀联合依那普利治疗伴白蛋白尿DN患者,可改善血管内皮功能和肾功能,提高临床治疗效果。

Objective: To investigate the clinical effect of atorvastatin combined with enalapril on diabetic nephropathy(DN)patients complicated with albuminuria. Methods: A total of 122 DN patients complicated with albuminuria were selected and randomized into the study group and control group, each with 61 cases. On the basis of routine blood glucose control, the control group were treated with enalapril, while the research group were treated with atorvastatin combined with enalapril. The total effective rate, renal function indexes: urinary albumin excretion rate(UAER), 24 h urine protein quantitative(24 h UPR), micro-albuminuria(MAU), α1-microglobulin(α1-MG), β2-microglobulin(β2-MG), vascular endothelial function indexes: nitric oxide(NO), endothelin(ET), serum cystatin C(CysC), homocysteine(Hcy)levels before and after treatment, and the incidence of adverse reactions were compared between the two groups. Results: The total effective rate in the study group was 93.44%, which was higher than 75.41% in the control group, and the differences were statistically significant(P<0.05);after treatment, UAER, 24 h UPR, MAU, α1-MG, β2-MG were reduced in both groups, and the study group reduced more than the control group(P< 0.05);NO level increased while the levels of ET, CysC, and Hcy decreased in both groups, and study group was better than the control group(P<0.05);and there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: Atorvastatin combined with enalapril has a significant clinical effect in the treatment of DN patients complicated with albuminuria, which can effectively improve their vascular endothelial function and renal function.