来氟米特联合缬沙坦治疗早期糖尿病肾病的临床疗效及其对肾功能的影响

发布时间：2018-01-25 21:43

本文关键词： 糖尿病肾病来氟米特缬沙坦免疫抑制　出处：《中国现代医学杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的比较来氟米特(LEF)联合缬沙坦与其他常见的联合用药治疗早期糖尿病肾病(DN)患者的临床疗效。方法选取2013年1月-2014年12月该院门诊与病房收治的DN患者189例,其中男性91例,女性98例。按随机数字表法将DN患者分为4组,其中缬沙坦组48例,仅用缬沙坦常规治疗;LEF组47例,使用缬沙坦联合LEF治疗;前列地尔组47例,使用缬沙坦联合前列地尔治疗;贝那普利组47例,使用缬沙坦联合贝那普利治疗。比较各组治疗前后的空腹血糖(FPG)、平均动脉压(MAP)、血肌酐(Scr)、尿素氮(BUN)、24 h尿蛋白定量(24 h Upro)及治疗有效率。结果 4组患者治疗总有效率比较,差异无统计学意义。4组患者的各项指标在治疗前比较,差异无统计学意义。治疗后,LEF组FPG水平最低,缬沙坦组与贝那普利组FPG、MAP、Scr、BUN、24 h Upro比较,差异有统计学意义;LEF组MAP、BUN水平最低,与其他组比较其下降值差异无统计学意义;LEF组24 h Upro最低,与缬沙坦组比较,差异有统计学意义;LEF组Scr水平低于缬沙坦组和前列地尔组,其下降值差异有统计学意义,LEF组Scr水平与贝那普利组比较,差异无统计学意义。结论 LEF联合缬沙坦治疗早期DN,相对于常见的缬沙坦联合前列地尔或贝那普利具有较好的整体疗效,不良反应少,值得临床推广。
[Abstract]:Objective to compare leflunomide with valsartan in the treatment of early diabetic nephropathy (DN). Methods from January 2013 to December 2014, 189 patients with DN were selected. Among them, 91 cases were male and 98 cases were female. According to the method of random number table, DN patients were divided into 4 groups, 48 cases of valsartan group were treated with valsartan routine therapy only; In LEF group, 47 cases were treated with valsartan combined with LEF. In the alprostadil group, 47 cases were treated with valsartan combined with alprostadil. 47 patients in benazepril group were treated with valsartan combined with benazepril. Urea nitrogen bun 24 h urine protein ration 24 h Upro.Results the total effective rate of the four groups was compared. After treatment, the level of FPG in lef group was the lowest, and that in valsartan group and benazepril group was the lowest. There was significant difference in 24 h Upro of Scrr Bun. The LEF group had the lowest level of LEF bun, and there was no significant difference in the decreasing value between the LEF group and the other groups. Compared with valsartan group, the Upro of LEF group was the lowest at 24 h, the difference was statistically significant. The level of Scr in LEF group was lower than that in valsartan group and alprostadil group. There was significant difference in Scr level between Lef group and benazepril group. Conclusion compared with valsartan combined with alprostadil or benazepril, LEF combined with valsartan has a better overall curative effect than valsartan combined with alprostadil or benazepril.
【作者单位】：北京市丰台中西医结合医院老年科;
【分类号】：R587.2;R692.9
【正文快照】： 糖尿病是慢性肾脏疾病(chronic kidney dis-ease,CKD)的主要原因,其中2型糖尿病进展为肾脏损害,即为糖尿病肾病(diabetic nephropathy,DN)。糖尿病肾病的发病机制较复杂,在中期尿蛋白的排出增加,大量血浆蛋白从肾小球滤过,导致肾小球硬化[1]。控制蛋白尿已经成为临床研究与治

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