羟苯磺酸钙治疗早期糖尿病肾病的疗效观察.docVIP

羟苯磺酸钙治疗早期糖尿病肾病的疗效观察 　　作者：董静,梁翠格,张晓倩,李明龙,刘占峰　　作者单位：山东大学附属省立医院内分泌科， 济南 250021;山东省临沂市人民医院内分泌科， 山东 临沂 276003;山东省千佛山医院内分泌科， 济南 250014 　　【摘要】目的 观察羟苯磺酸钙治疗早期糖尿病肾病的临床疗效。方法 早期糖尿病肾病患者42例，随机分成两组：对照组，21例，常规降糖治疗;治疗组，21例，常规降糖加用羟苯磺酸钙500?mg tid治疗，疗程12周。观察治疗前后24?h尿白蛋白排出量(UAE)、血浆内皮素(ET)、血清一氧化氮(NO)、空腹血糖、餐后2?h血糖、糖化血红蛋白、肝肾功能的变化。结果 治疗组治疗后，UAE显著降低(P0.01)，ET降低，NO升高;空腹血糖、餐后2?h血糖、糖化血红蛋白、肝肾功能差异无统计学意义。对照组治疗后，UAE、ET、NO、空腹血糖、糖化血红蛋白、肝肾功能差异无统计学意义。结论 羟苯磺酸钙能减少早期糖尿病肾病患者的尿白蛋白排泄，延缓糖尿病肾病的进展;并通过降低血浆ET、增加血清NO以实现对肾脏的保护作用。 　　【关键词】 糖尿病肾病;羟苯磺酸钙;内皮素;一氧化氮 　　基金项目：山东省科技厅新上有资项目(2001BB1DBA1)。 　　DONG Jing,　LIANG Cuige,　ZHANG Xiaoqian,　LI Minglong,LIU Zhanfeng, ZHAO Jiajun,　YU Guina 　　Department of Endocrine, 1. Provincial Hospital affiliated to Shandong University, Jinan 250021, China; 　　2. Linyi People′s Hospital, Linyi 276003, Shandong, China; 　　3. Shandong Qianfoshan Hospital, Jinan 250014, China 　　To investigate the clinical effects of calcium dobesilate on early diabetic nephropathy. Methods 42 patients with early diabetic nephropathy were randomly divided into the treatment and control groups. All the patients were given treatment to control blood glucose and 21 patients in the treatment group were treated with calcium dobesilate (500?mg, three times per day) for 12 weeks. Urinary albumin excretion, plasma endothelin, serum nitric oxide, serum glucose, glycosylated heamoglobin A1c, hepatic and renal function were determined before and after the treatment. Results After 12 weeks of treatment, in the treatment group the levels of UAE were significantly decreased(P0.01), the levels of ET were decreased, the levels of NO were increased, and the levels of serum glucose and HbA1c had no changes. However, the levels of UAE, ET, NO, serum glucose and HbA1c had no changes in the control group. Conclusion Calcium dobesilate can decrease the levels of UAE in patients with early diabetic nephropathy and postpone the development of diabetic nephropathy, which may be due to its correcti