胰激肽原酶联合厄贝沙坦治疗老年糖尿病肾病患者的效果

Effects of Pancreatic kininogenase combined with Irbesartan in treatment of elderly patients with diabetic nephropathy

目的:观察胰激肽原酶联合厄贝沙坦治疗老年糖尿病肾病(DN)患者的效果。方法:选取2020年5月至2022年5月该院收治的84例老年DN患者进行前瞻性研究,以随机数字表法将其分为对照组和研究组各42例。对照组采用厄贝沙坦治疗,研究组在对照组基础上联合胰激肽原酶治疗,比较两组临床疗效、治疗前后血糖指标[空腹血糖(FBG)、餐后2 h血糖(2hPG)、平均血糖波动幅度(MAGE)、血糖标准差(SDBG)]水平、肾功能指标[24 h尿蛋白(24hUpro)、尿蛋白排泄率(UAER)]水平、血管内皮功能指标[血管性血友病因子(vWF)、内皮素-1(ET-1)]水平,血清可溶性肿瘤坏死因子受体Ⅰ(sTNFR-Ⅰ)、结缔组织生长因子(CTGF)、丙二醛(MDA)和超氧化物歧化酶(SOD)水平。结果:研究组治疗总有效率为95.24%(40/42),高于对照组的78.57%(33/42),差异有统计学意义(P<0.05);治疗后,研究组FBG、2hPG、MAGE、SDBG、24hUpro、UAER、vWF、ET-1水平均低于对照组,差异有统计学意义(P<0.05);治疗后,研究组血清sTNFR-Ⅰ、CTGF、MDA水平均低于对照组,SOD水平高于对照组,差异有统计学意义(P<0.05)。结论:胰激肽原酶联合厄贝沙坦治疗老年DN患者可提高治疗总有效率和SOD水平,降低血糖指标、肾功能指标、血管内皮功能指标、sTNFR-Ⅰ、CTGF和MDA水平,效果优于单纯厄贝沙坦治疗。

Objective:To observe effects of Pancreatic kininogenase combined with Irbesartan in treatment of elderly patients with diabetic nephropathy(DN).Methods:A prospective study was conducted on 84 elderly patients with DN admitted to this hospital from May 2020 to May 2022.They were divided into control group and study group by using the random number table method,42 cases in each group.The control group was treated with Irbesartan,while the study group was treated with Pancreatic kininogenase on the basis of that of the control group.The clinical efficacy,the blood glucose index levels[fasting blood glucose(FBG),2-hour postprandial blood glucose(2hPG),mean amplitude of glycemic excursions(MAGE),standard deviation of blood glucose(SDBG)],the renal function index levels[24-hour urinary protein(24hUpro),urinary protein excretion rate(UAER)],the vascular endothelial function index levels[von Willebrand factor(vWF),endothelin-1(ET-1)],and the serum levels of soluble tumor necrosis factor receptor-I(sTNFR-I),connective tissue growth factor(CTGF),malondialdehyde(MDA)and superoxide dismutase(SOD)were compared between the two groups before and after the treatment.Results:The total effective rate of treatment in the study group was 95.24%(40/42),which was higher than 78.57%(33/42)in the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of FBG,2hPG,MAGE,SDBG,24hUpro,UAER,vWF and ET-1 in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).Further,after the treatment,the levels of serum sTNFR-I,CTGF and MDA in the study group were lower than those in the control group,the level of SOD was higher than that in the control group,and the differences were statistically significant(P<0.05).Conclusions:Pancreatic kininogenase combined with Irbesartan in the treatment of the elderly DN patients can improve the total effective rate of treatment and the SOD levels,reduce the levels of blood glucose indexes,renal the function indexes,vascular endothelial function indexes,sTNFR-I,CTGF and MDA.Moreover,it is superior to single Irbesartan treatment.