替米沙坦联合螺内酯治疗早期糖尿病肾病的疗效及对微量白蛋白尿、脑钠肽的影响.docVIP

替米沙坦联合螺内酯治疗早期糖尿病肾病的疗效及对微量白蛋白尿、脑钠肽的影响 　　[摘要] 目的 探讨替米沙坦联合螺内酯治疗早期糖尿病肾病的疗效及对微量白蛋白尿、脑钠肽的影响。方法 选择我院80例早期糖尿病肾病患者，按入院顺序随机分为两组各40例。研究组患者使用替米沙坦联合螺内酯进行治疗，对照组患者仅使用替米沙坦治疗，比较两组患者治疗有效率，及治疗前后尿微量白蛋白和血浆脑钠肽水平变化。 结果 研究组患者治疗总有效率为92.5%，明显高于对照组65.0%，差异具有统计学意义（P0.05）；研究组患者经治疗后尿微量白蛋白及血浆脑钠肽水平分别为（134.4±29.8）mg/d、（285.8±76.9）ng/L，明显低于治疗前（245.8±53.5）mg/d、（587.4±89.6）ng/L和对照组（189.4±32.6）mg/d、（369.7±80.4）ng/L，差异具有统计学意义（P0.05）。结论 替米沙坦联合螺内酯治疗早期糖尿病患者疗效显著，可明显改善患者症状，延缓肾小球纤维化，值得临床推广应用。 　　[关键词] 替米沙坦；螺内酯；糖尿病；微量白蛋白；脑钠肽 　　[中图分类号] R587.2；R692.2 [文献标识码] B [文章编号] 1673-9701（2014）22-0033-03 　　[Abstract] Objective To explore the therapeutic effect of telmisartan combined with spironolactone in treatment of early diabetic nephropathy and its influence on microalbuminuria and brain natriuretic peptide. Methods Eighty cases of patients with early diabetic nephropathy in our hospital were divided into two groups with 40 cases in each. The study group was treated with telmisartan combined with spironolactone， the control group only treated with telmisartan， and the treatment efficiency and the changes of urinary albumin and the plasma brain natriuretic peptide levels before and after treatment were compared. Results The total effective rate of the study group was 92.5%， significantly higher than 65.0% of the control group， and the difference was significant（P0.05）； The study group’ urinary albumin and plasma brain natriuretic peptide levels were （134.4±29.8） mg/d and （285.8±76.9） ng/L after treatment， significantly lower than （245.8±53.5） mg/d and （587.4±89.6） ng/L before treatment and （189.4±32.6） mg/d and （369.7±80.4） ng/L of the control group， and the difference was significant（P0.05）. Conclusion Telmisartan combined with spironolactone has a significant effect on the treatment of early diabetic， which can significantly improve the symptoms of patients and retard the process of glomerular fibrosis， and that is worthy of clinical application. 　　[Key words] Telmisartan； Spironolactone； Diabetes； Microalbumi