CAJ | 학술논문

目的：观察缬沙坦和羟苯磺酸钙联合治疗对老年早期糖尿病肾病( DN)患者内皮素( ET)和血清胱抑素C( CysC)的影响。方法选择老年2型糖尿病早期肾病患者76例均分为4组,每组19例。对照组：给予常规治疗；羟苯磺酸钙(安多明)组：安多明0．25 g,bid,po；缬沙坦(代文)组：代文80 mg,qd,po；羟苯磺酸钙+缬沙坦组(联合组)：安多明0．25 g,bid,po+代文80 mg,qd,po。观察治疗前、治疗1个月及6个月后各组患者ET和胱抑素C的水平变化。结果羟苯磺酸钙组：治疗后Fib水平较治疗前明显下降( P<0．05)；缬沙坦组：治疗后血压水平明显下降(P<0．01)；联合组：治疗后血压及Fib水平均明显下降(P<0．01及P<0．05)。治疗1个月后,三组治疗组ET和胱抑素C水平较治疗前明显下降( P<0．05),三组治疗组与对照组比较,上述指标差异有统计学意义(P<0．05)；治疗6个月后,三组治疗组 ET 和胱抑素 C 水平较治疗前水平进一步下降(P <0．01),与对照组比较,差异有统计学意义(P<0．01)。结论羟苯磺酸钙和缬沙坦联合治疗,可以降低老年早期糖尿病肾病患者ET和血清胱抑素C的水平。联合用药的效果明显优于药物单用的疗效。
목적：관찰힐사탄화간분광산개연합치료대노년조기당뇨병신병( DN)환자내피소( ET)화혈청광억소C( CysC)적영향。방법선택노년2형당뇨병조기신병환자76례균분위4조,매조19례。대조조：급여상규치료；간분광산개(안다명)조：안다명0．25 g,bid,po；힐사탄(대문)조：대문80 mg,qd,po；간분광산개+힐사탄조(연합조)：안다명0．25 g,bid,po+대문80 mg,qd,po。관찰치료전、치료1개월급6개월후각조환자ET화광억소C적수평변화。결과간분광산개조：치료후Fib수평교치료전명현하강( P<0．05)；힐사탄조：치료후혈압수평명현하강(P<0．01)；연합조：치료후혈압급Fib수평균명현하강(P<0．01급P<0．05)。치료1개월후,삼조치료조ET화광억소C수평교치료전명현하강( P<0．05),삼조치료조여대조조비교,상술지표차이유통계학의의(P<0．05)；치료6개월후,삼조치료조 ET 화광억소 C 수평교치료전수평진일보하강(P <0．01),여대조조비교,차이유통계학의의(P<0．01)。결론간분광산개화힐사탄연합치료,가이강저노년조기당뇨병신병환자ET화혈청광억소C적수평。연합용약적효과명현우우약물단용적료효。
Objective To explore the effect of calcium dobesilate combined with valsartan treatment on the level of endothelin and cystatin-C in the elderly patients with early diabetic nephropathy. Methods 76 cases of elderly patients with early diabetic nephropathy were divided into four groups,19 cases in each group,control group was given conventional treatment. Calcium dobesilate group was given calcium dobesilate,0. 25 g,bid,po. Valsartan group was given valsartan 80 mg,qd,po. Calcium dobesilate plus alsartan group was given calcium dobesilate,0. 25 g,bid,po and valsartan 80 mg, qd, po. The level of endothelin and cystatin-C were detected before treatment and one month, six months after the treatment. Results Calcium dobesilate group:the level of Fib decreased obviously compared with be-fore treatment(P<0. 05). Valsartan group:the level of blood pressure decreased obviously after treatment. Calcium do-besilate plus alsartan group:the level of blood pressure and Fib decreased obviously after treatment ( P<0. 01 or P<0. 05) . Compared with before treatment,the level of endothelin and cystatin-C of the three treatment groups markedly decreased after one month treatment and there was significant difference compared with control group(P<0. 05);Com-pared with before treatment,the level of endothelin and cystatin-C of the three treatment groups markedly decreased af-ter six months treatment and there was significant difference compared with control group(P<0. 01). The level of uri-nary albumin excretion rate and endothelin and cystatin-C were markedly decreased after six months treatment of calci-um dobesilate ( P<0. 01 ) and valsartan and co-treatment ( P<0. 01 ) . Conclusion Calcium dobesilate plus valsartan can decrease the level of endothelin and cystatin-C of early diabetic nephropathy patients,the effect of co-treatment is better than that of single drug treatment.