中国现代医生
中國現代醫生
중국현대의생
CHINA MODERN DOCTOR
2015年
11期
32-34,38
,共4页
糖尿病肾病%缬沙坦%前列地尔
糖尿病腎病%纈沙坦%前列地爾
당뇨병신병%힐사탄%전렬지이
Diabetic nephropathy%Valsartan%Alprostadil
目的：观察缬沙坦联合前列地尔治疗糖尿病肾病的临床疗效。方法选择本院2010年1月~2014年1月收治的糖尿病肾病患者84例，根据治疗方法不同分为观察组和对照组，每组各42例，两组患者均予优质低蛋白糖尿病饮食，并予降糖(胰岛素)、降压、抗凝等对症治疗。对照组加用前列地尔注射液10μg加入生理盐水20 mL静推，每日1次，连用12周。观察组在此基础上给予缬沙坦80 mg，每日2次，口服，4周为1个疗程，连用12周。比较两组患者治疗前后24 h尿蛋白定量、肌酐、尿素氮的变化情况及两组患者治疗后的疗效。结果两组患者治疗前24 h尿蛋白定量、Cr、BUN水平比较差异无统计学意义(P>0.05)。治疗后，两组患者Cr、BUN水平较治疗前未见明显变化，但观察组24 h尿蛋白定量较治疗前及对照组显著降低，差异有统计学意义(P<0.05)。治疗后，观察组总有效率为90.5%，对照组总有效率为73.8%，观察组总有效率显著高于对照组，差异有统计学意义(P<0.05)。整个治疗过程中，对照组出现一过性心悸1例，头晕、头痛3例，咳嗽1例。观察组出现咳嗽2例，头晕、头痛2例，严重程度均较轻,未影响继续治疗。结论缬沙坦联合前列地尔治疗糖尿病肾病疗效确切，可以明显改善患者的肾功能，值得临床推广应用。
目的：觀察纈沙坦聯閤前列地爾治療糖尿病腎病的臨床療效。方法選擇本院2010年1月~2014年1月收治的糖尿病腎病患者84例，根據治療方法不同分為觀察組和對照組，每組各42例，兩組患者均予優質低蛋白糖尿病飲食，併予降糖(胰島素)、降壓、抗凝等對癥治療。對照組加用前列地爾註射液10μg加入生理鹽水20 mL靜推，每日1次，連用12週。觀察組在此基礎上給予纈沙坦80 mg，每日2次，口服，4週為1箇療程，連用12週。比較兩組患者治療前後24 h尿蛋白定量、肌酐、尿素氮的變化情況及兩組患者治療後的療效。結果兩組患者治療前24 h尿蛋白定量、Cr、BUN水平比較差異無統計學意義(P>0.05)。治療後，兩組患者Cr、BUN水平較治療前未見明顯變化，但觀察組24 h尿蛋白定量較治療前及對照組顯著降低，差異有統計學意義(P<0.05)。治療後，觀察組總有效率為90.5%，對照組總有效率為73.8%，觀察組總有效率顯著高于對照組，差異有統計學意義(P<0.05)。整箇治療過程中，對照組齣現一過性心悸1例，頭暈、頭痛3例，咳嗽1例。觀察組齣現咳嗽2例，頭暈、頭痛2例，嚴重程度均較輕,未影響繼續治療。結論纈沙坦聯閤前列地爾治療糖尿病腎病療效確切，可以明顯改善患者的腎功能，值得臨床推廣應用。
목적：관찰힐사탄연합전렬지이치료당뇨병신병적림상료효。방법선택본원2010년1월~2014년1월수치적당뇨병신병환자84례，근거치료방법불동분위관찰조화대조조，매조각42례，량조환자균여우질저단백당뇨병음식，병여강당(이도소)、강압、항응등대증치료。대조조가용전렬지이주사액10μg가입생리염수20 mL정추，매일1차，련용12주。관찰조재차기출상급여힐사탄80 mg，매일2차，구복，4주위1개료정，련용12주。비교량조환자치료전후24 h뇨단백정량、기항、뇨소담적변화정황급량조환자치료후적료효。결과량조환자치료전24 h뇨단백정량、Cr、BUN수평비교차이무통계학의의(P>0.05)。치료후，량조환자Cr、BUN수평교치료전미견명현변화，단관찰조24 h뇨단백정량교치료전급대조조현저강저，차이유통계학의의(P<0.05)。치료후，관찰조총유효솔위90.5%，대조조총유효솔위73.8%，관찰조총유효솔현저고우대조조，차이유통계학의의(P<0.05)。정개치료과정중，대조조출현일과성심계1례，두훈、두통3례，해수1례。관찰조출현해수2례，두훈、두통2례，엄중정도균교경,미영향계속치료。결론힐사탄연합전렬지이치료당뇨병신병료효학절，가이명현개선환자적신공능，치득림상추엄응용。
Objective To observe the clinical efficacy of valsartan combined with alprostadil in treatment of diabetic nephropathy. Methods Selected 84 cases of diabetic nephropathy patients in our hospital from January 2010 to January 2014. According to the different treatment methods they were divided into observation group and control group, each of 42 cases, two groups were treated with high quality low protein diabetic diet, and received the hypoglycemic (insulin), symptomatic treatment, anticoagulant buck. The control group was treated with alprostadil injection 10 μg with 20 mL of physiological saline bolus, once a day, for 12 weeks. On the basis of control group, the observation group was given valsartan 80 mg, 2 times daily, orally, 4 weeks for a course of treatment for 12 weeks. The changes of 24 hours urinary protein, creatinine, urea nitrogen before and after treatment and the effects of two groups after treatment were com-pared. Results The 24 hours urine protein, Cr, BUN levels before treatment had no significant difference between two groups of patients (P>0.05). After treatment, two groups of patients with Cr, BUN levels had no obvious changes with those before therapy, but of 24 hour urinary protein quantitative the observation group significantly decreased than be-fore treatment and control group after treatment, there was statistically significant difference between two groups (P<0.05). After treatment, the observation group's efficiency was 90.5%, control group was 73.8%, observation group's effi-ciency was significantly higher than the control group, there was significant difference between two groups (P<0.05). Throughout the course of treatment, the control group one case of transient palpitations, three cases of dizziness and headache, one case of cough. In the observation group two cases of cough, two cases of dizziness and headache, which were mild severity and did not affect the continued treatment. Conclusion The therapeutic effect of valsartan com-bined with alprostadil in treatment of diabetic nephropathy is accurate, can significantly improve renal function, is wor-thy of promotion and application.
