缬沙坦联合前列地尔治疗糖尿病肾病的临床疗效观察.docVIP

缬沙坦联合前列地尔治疗糖尿病肾病的临床疗效观察 　　[摘要] 目的 观察缬沙坦联合前列地尔治疗糖尿病肾病的临床疗效。 方法 选择本院2010年1月～2014年1月收治的糖尿病肾病患者84例，根据治疗方法不同分为观察组和对照组，每组各42例，两组患者均予优质低蛋白糖尿病饮食，并予降糖（胰岛素）、降压、抗凝等对症治疗。对照组加用前列地尔注射液10 μg加入生理盐水20 mL静推，每日1次，连用12周。观察组在此基础上给予缬沙坦80 mg，每日2次，口服，4周为1个疗程，连用12周。比较两组患者治疗前后24 h尿蛋白定量、肌酐、尿素氮的变化情况及两组患者治疗后的疗效。 结果 两组患者治疗前24 h尿蛋白定量、Cr、BUN水平比较差异无统计学意义（P0.05）。治疗后，两组患者Cr、BUN水平较治疗前未见明显变化，但观察组24 h尿蛋白定量较治疗前及对照组显著降低，差异有统计学意义（P0.05）。治疗后，观察组总有效率为90.5%，对照组总有效率为73.8%，观察组总有效率显著高于对照组，差异有统计学意义（P0.05）。整个治疗过程中，对照组出现一过性心悸1例，头晕、头痛3例，咳嗽1例。观察组出现咳嗽2例，头晕、头痛2例，严重程度均较轻，未影响继续治疗。 结论 缬沙坦联合前列地尔治疗糖尿病肾病疗效确切，可以明显改善患者的肾功能，值得临床推广应用。 　　[关键词] 糖尿病肾病；缬沙坦；前列地尔 　　[中图分类号] R587.2 [文献标识码] B [文章编号] 1673-9701（2015）11-0032-03 　　[Abstract] Objective To observe the clinical efficacy of valsartan combined with alprostadil in treatment of diabetic nephropathy. Methods Selected 84 cases of diabetic nephropathy patients in our hospital from January 2010 to January 2014. According to the different treatment methods they were divided into observation group and control group， each of 42 cases， two groups were treated with high quality low protein diabetic diet， and received the hypoglycemic （insulin）， symptomatic treatment， anticoagulant buck. The control group was treated with alprostadil injection 10 μg with 20 mL of physiological saline bolus， once a day， for 12 weeks. On the basis of control group， the observation group was given valsartan 80 mg， 2 times daily， orally， 4 weeks for a course of treatment for 12 weeks. The changes of 24 hours urinary protein， creatinine， urea nitrogen before and after treatment and the effects of two groups after treatment were compared. Results The 24 hours urine protein， Cr， BUN levels before treatment had no significant difference between two groups of patients（P0.05）. After treatment， two groups of patients with Cr， BUN levels had no obvious changes with those before therapy， but of 24 hour urinary protein quantitative the observation group significantly decreased than before treatment and control gro