缬沙坦治疗早期糖尿病肾病患者对其凝血功能及尿微量白蛋白排泄率的影响

Effect of valsartan on coagulation function and urinary albumin excretion rates in patients with early diabetic nephropathy

目的探讨缬沙坦治疗早期糖尿病肾病(DN)对患者凝血功能与尿微量白蛋白排泄率(UAER)的影响。方法选取2020年1月至2021年3月本院收治的82例早期DN患者作为研究对象,随机分为实验组与对照组,每组41例。对照组给予胰激肽原酶联合安慰剂治疗,实验组在对照组基础上给予缬沙坦治疗,比较两组治疗前后肾功能指标[尿素氮(BUN)、血肌酐(SCr)]与凝血功能指标[凝血酶时间(TT)、活化部分凝血活酶时间(APTT)与纤维蛋白原(FIB)]及UAER。结果治疗前,两组BUN、SCr水平比较差异无统计学意义;治疗后,两组BUN、SCr水平均低于治疗前,且实验组低于对照组,差异有统计学意义(P<0.05)。治疗前,两组TT、APTT与FIB水平比较差异无统计学意义;治疗后,两组TT与APTT均长于治疗前,FIB水平低于治疗前,且实验组TT与APTT均长于对照组,FIB水平低于对照组,差异有统计学意义(P<0.05)。治疗前,两组UAER比较差异无统计学意义。治疗后,两组UAER均低于治疗前,且实验组低于对照组,差异有统计学意义(P<0.05)。结论缬沙坦治疗DN,可有效降低UAER,改善患者肾功能与凝血功能,值得临床推广应用。

Objective To investigate the effects of valsartan in the treatment of early diabetic nephropathy(DN)on coagulation function and urinary microalbumin excretion rate(UAER)in patients with DN.Methods A total of 82 patients with early DN admitted to our hospital from January 2020 to March 2021 were selected as the research subjects,and they were randomly divided into experimental group and control group,with 41 cases in each group.The control group was treated with pancreatic kininogenase combined with placebo,and the experimental group was treated with valsartan based on the control group,the renal function indexes(urea nitrogen[BUN],serum creatinine[SCr]),coagulation function indexes(thrombin time[TT],activated partial thrombin time[APTT]and fibrinogen[FIB])and UAER before and after treatment were compared between the two groups.Results Before treatment,there was no significant difference in BUN and SCr levels between the two groups;after treatment,BUN and SCr levels of the two groups were lower than those before treatment,and the experimental group was lower than the control group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the TT,APTT and FIB level between the two groups;after treatment,TT and APTT of the two groups were longer than those before treatment,and FIB levels were lower than that before treatment,and TT and APTT in the experimental group were longer than those in the control group,FIB level was lower than that in v the control group,the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in UAER between the two groups;after treatment,UAER of the two groups was lower than before treatment,and the experimental group was lower than the control group,the difference was statistically significant(P<0.05).Conclusion In the treatment of DN,valsartan can effectively reduce UAER,improve renal function and coagulation function of patients,and is worthy of clinical promotion and application.