CAJ | 학술논문

目的：研究糖尿病性肾脏疾病（DKD）患者在不同分期的临床治疗效果。方法选取2010年8月至2013年8月来我院治疗的40例蛋白尿﹤0.5 g/24 h 的 DKD 患者为早期组，选取40例蛋白尿≥0.5 g/24 h 的患者为中期组。两组患者给予联合应用缬沙坦和贝那普利，进行3个月治疗，研究糖尿病的调脂、降血压，测量患者的血压、血糖、糖化血红蛋白（HbA1c）、内生肌酐清除率（Ccr）、血清肌酐（Scr）、尿素氮（BUN）、尿总蛋白排泄率（UPER）等指标。对80例患者进行12个月的随访。结果治疗后两组患者的血压、血糖和 HbA1c 的值均有所下降，且在治疗前后差异有统计学意义（ P ﹤0.05）。早期组在治疗前后的 UPER 值的变化程度显著，差异有统计学有意义（ P ﹤0.05）；中期组患者在治疗前后的 UPER 值的变化程度不显著，差异无统计学意义（ P ﹥0.05）。两组患者在治疗前后 BUN、Ccr 和 Scr 的净变化值间差异显著，有统计学意义（ P ﹤0.01）。早期组和中期组患者的1年肾脏存活率分别为97.50％和72.50％，差异有统计学意义（ P ﹤0.05）。结论对 DKD 患者进行临床干预，早期的 DKD 患者从中获益最大。
목적：연구당뇨병성신장질병（DKD）환자재불동분기적림상치료효과。방법선취2010년8월지2013년8월래아원치료적40례단백뇨﹤0.5 g/24 h 적 DKD 환자위조기조，선취40례단백뇨≥0.5 g/24 h 적환자위중기조。량조환자급여연합응용힐사탄화패나보리，진행3개월치료，연구당뇨병적조지、강혈압，측량환자적혈압、혈당、당화혈홍단백（HbA1c）、내생기항청제솔（Ccr）、혈청기항（Scr）、뇨소담（BUN）、뇨총단백배설솔（UPER）등지표。대80례환자진행12개월적수방。결과치료후량조환자적혈압、혈당화 HbA1c 적치균유소하강，차재치료전후차이유통계학의의（ P ﹤0.05）。조기조재치료전후적 UPER 치적변화정도현저，차이유통계학유의의（ P ﹤0.05）；중기조환자재치료전후적 UPER 치적변화정도불현저，차이무통계학의의（ P ﹥0.05）。량조환자재치료전후 BUN、Ccr 화 Scr 적정변화치간차이현저，유통계학의의（ P ﹤0.01）。조기조화중기조환자적1년신장존활솔분별위97.50％화72.50％，차이유통계학의의（ P ﹤0.05）。결론대 DKD 환자진행림상간예，조기적 DKD 환자종중획익최대。
Objective To study the clinical effect of treatment in patients with diabetic kidney disease(DKD)at different stages. Meth-ods A total of 40 cases of DKD with urinary protein ﹤ 0. 5 g/ 24 h in this hospital during August 2010 to August 2013 were selected as early group,then 40 cases of DKD with urinary protein ≥ 0. 5 g/ 24 h were allocated as middle group,and they were treated with valsartan and benaze-pril for 3 months for lowering blood pressure and lipids,then their blood pressure,blood glucose,HbA1c,serum creatinine,urea nitrogen,the u-rinary protein excretion rate and other indicators were examined and compared,and 80 patients of them were followed up for 12 months. Results After treatment,the BP,and blood levels of glucose and HbA1c were decreased in these 2 groups,and the difference in these indicators between pre - treatment and post - treatment was statistically significant( P ﹤ 0. 05). The difference in UPER of early group before and after treatment was statistically significant( P ﹤ 0. 05);the degree of changes in UPER of patients in second group before and after treatment was not statistically sig-nificant( P ﹥0. 05). The difference in changes of BUN,Ccr and Scr in these two groups before and after treatment was statistically significant( P ﹤0. 05). The 1 year renal survival rates in these 2 groups were 97. 50% and 72. 50% respectively,and their difference was statistically significant( P ﹤0. 05). Conclusion Clinical intervention on patients with DKD,the benefit for patients with early DKD is the greatest.