来氟米特对糖尿病肾病蛋白尿的干预治疗及其效果的研究

发布时间：2018-12-18 01:15

【摘要】：目的：观察来氟米特对糖尿病肾病（Diabetic Nephropathy DN）蛋白尿的作用及安全性。方法：收集青海省人民医院2012年12月至2014年1月明确诊断为DN的患者30例（均经过肾活检），且24小时尿蛋白定量≥1g/d，随机分为2组，对照组（15例），应用血管紧张素受体II拮抗剂(ARB),缬沙坦(valsartan)（商品名：代文）80mg/日；治疗组（15例），在常规剂量缬沙坦80mg/日基础上，给予来氟米特(leflunomide,LEF)（商品名：妥抒）20mg/日，分别观察治疗前，治疗后4周（W）及12周（W）患者的24小时尿蛋白定量、血清白蛋白（ALB）,超敏C反应蛋白（Hs-CRP）、尿素氮(BUN)，血肌酐(Scr)，肝功，血常规的变化。结果：1. DN患者24小时尿蛋白定量与Hs-CRP呈正相关（p＜0.05），与ALB呈负相关（p＜0.05），与Scr无相关性（p＞0.05）。2.两组治疗后4W及12W,24小时尿蛋白定量、超敏C反应蛋白均有下降，血清白蛋白上升，具有统计学意义（p0.05），治疗组与对照组相比，治疗后4W及12W，，治疗组患者24小时尿蛋白定量、Hs-CRP下降更明显，ALB上升更明显，具有统计学意义（p0.05）。结论：1.来氟米特联用缬沙坦治疗DN蛋白尿，疗效更明显，优于单独应用缬沙坦。2.来氟米特对患者的肾功能无明显影响，因此临床应用来氟米特治疗DN蛋白尿是一种安全、有效的方法。
[Abstract]:Objective: to observe the effect and safety of leflunomide on (Diabetic Nephropathy DN) proteinuria in diabetic nephropathy. Methods: from December 2012 to January 2014, 30 patients with DN were selected from Qinghai Provincial people's Hospital, who underwent renal biopsy, and were randomly divided into two groups: control group (n = 15). (ARB), valsartan (valsartan) (, an angiotensin receptor II antagonist, was used for 80mg/ days. In the treatment group (n = 15), on the basis of conventional valsartan 80mg/ day, leflunomide,LEF (trade name: toxie) 20mg/ day was given to observe before treatment. The changes of 24 hour urine protein, serum albumin (ALB), hypersensitive C-reactive protein (Hs-CRP), urea nitrogen (BUN), serum creatinine (Scr), liver function and blood routine in patients with (W) and (W) at 4 weeks and 12 weeks after treatment. Results: 1. There was a positive correlation between 24 hour urine protein and Hs-CRP (p < 0. 05), a negative correlation with ALB (p < 0. 05), and no correlation with Scr (p > 0. 05). 2. Compared with the control group, the serum albumin of the treatment group was significantly higher than that of the control group (p0.05), and the levels of urinary protein in the treatment group were significantly higher than those in the control group (P < 0.05), and the levels of serum albumin in the treatment group were significantly higher than those in the control group (P < 0.05). In the treatment group, urinary protein in 24 hours was measured, Hs-CRP decreased more significantly and ALB increased significantly (p0.05). Conclusion: 1. Leflunomide combined with valsartan was more effective than valsartan alone in the treatment of DN proteinuria. Leflunomide has no effect on renal function, so it is a safe and effective method to treat DN proteinuria.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692.5

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