CAJ | 학술논문

目的：评价羟苯磺酸钙和贝那普利联合治疗早期糖尿病肾病（ DN ）的疗效与安全性。方法入选DN患者102例，随机分为A、B、C 3组，3组控制血糖方法相同。 A组34例口服羟苯磺酸钙1000 mg tid，B组33例口服贝那普利10 mg· d -1，C组35例口服羟苯磺酸钙1000 mg tid并联合贝那普利10 mg· d -1，均治疗12周，比较治疗前后3组平均动脉压（ MAP）、糖化血红蛋白（ HbA1 c）、血肌酐（ Scr）、肌酐清除率（ Ccr）、纤维蛋白原（ FIB）及尿白蛋白排泄率（UAER）的变化。结果3组患者治疗前后MAP、HbA1c、Scr、Ccr水平无明显变化（ P＞0.05）； A和 C组治疗后 FIB较治疗前显著下降（ P＜0.05）；3组患者治疗后UAER均有不同程度下降， C组下降更为显著（P ＜0.05）。 C组有1例皮肤过敏。结论羟苯磺酸钙和贝那普利联合治疗早期DN能有效降低UAER，且能降低FIB，能有效逆转或延缓早期DN进展，且药物不良反应少。
목적：평개간분광산개화패나보리연합치료조기당뇨병신병（ DN ）적료효여안전성。방법입선DN환자102례，수궤분위A、B、C 3조，3조공제혈당방법상동。 A조34례구복간분광산개1000 mg tid，B조33례구복패나보리10 mg· d -1，C조35례구복간분광산개1000 mg tid병연합패나보리10 mg· d -1，균치료12주，비교치료전후3조평균동맥압（ MAP）、당화혈홍단백（ HbA1 c）、혈기항（ Scr）、기항청제솔（ Ccr）、섬유단백원（ FIB）급뇨백단백배설솔（UAER）적변화。결과3조환자치료전후MAP、HbA1c、Scr、Ccr수평무명현변화（ P＞0.05）； A화 C조치료후 FIB교치료전현저하강（ P＜0.05）；3조환자치료후UAER균유불동정도하강， C조하강경위현저（P ＜0.05）。 C조유1례피부과민。결론간분광산개화패나보리연합치료조기DN능유효강저UAER，차능강저FIB，능유효역전혹연완조기DN진전，차약물불량반응소。
Objective To observe the effects and safety of dobesilate and benazepril combination therapy on early diabetic nephropathy ( DN).Methods One hundred and two cases of early DN patients were randomly divided into A, B, and C groups, and the same glyce-mic control method were adopted in three groups.Group A ( 34 pa-tients) were treated with dobesilate of 1000 mg 3 times a day orally, group B ( 33 patients) were treated with benazepril 10 mg a day oral-ly, and 35 patients in group C were treated with dobesilate of 1000 mg 3 times a day combined with enalapril 10 mg one day orally.Three groups were treated for l2 weeks.The changes of three groups before and after treatment in the mean arterial pressure ( MAP) , glycated he-moglobin ( HbA1 c ) , serum creatinine ( Scr ) , creatinine clearance rate ( Ccr ) , fibrinogen ( FIB ) and urinary albumin excretion rate ( UAER) were compared.Results Compared with pre-treatment, MAP, HbA1 c, Scr, Ccr levels of the three groups had no significant differences ( P>0.05 ) .FIB level of group A and C decreased signifi-cantly ( P <0.05 ) .UAER of three groups were decreased , and the group C decreased more significantly ( P<0.05 ).There was one case of skin allergies in group C.Conclusion Dobesilate and benazeprilcombination treatment for early diabetic nephropathy can effectively reduce UAER and FIB , reverse or slow the progress of early DN, with less adverse reactions.