CAJ | 학술논문

目的：观察阿托伐他汀联合厄贝沙坦治疗早期糖尿病肾病的疗效及对血清胱抑素 C 和脂联素水平的影响。方法将80例符合入组标准的早期糖尿病肾病患者按随机数字表法分为观察组40例和对照组40例，两组均给予常规糖尿病综合干预方法，对照组再口服厄贝沙坦150 mg／d，1次／d，观察组在对照组的基础上再口服阿托伐他汀20 mg／d，1次／d，两组患者均观察12周，治疗前后空腹抽血检测空腹血糖（FBG）、糖化血红蛋白（HbA1c），肾功能指标[血肌酐（Sc）r、尿素氮（BUN）、尿白蛋白排泄率（UAER）]，血脂指标[总胆固醇（TC）、甘油三酯（TG）]，血清胱抑素 C，脂联素，采用24 h 动态血压仪监测 DBP、SBP。结果观察组治疗后 DBP、SBP、Scr、BUN、UAER、TC、TG、胱抑素 C、脂联素均较治疗前明显降低（P ＜0．05或 P ＜0．01），但对照组治疗前后 BUN、TC、TG 无明显变化（P ＞0．05），观察组治疗后 Scr、UAER、TC、TG、胱抑素 C、脂联素明显低于对照组（P ＜0．05或 P ＜0．01）。结论阿托伐他汀联合厄贝沙坦能够有效控制血压，全面改善糖脂代谢，有效降低脂联素与血清胱抑素 C，减少胰岛素抵抗，抑制肾小球功能受损，改善肾功能，是防治早期糖尿病肾病的良好方法。
목적：관찰아탁벌타정연합액패사탄치료조기당뇨병신병적료효급대혈청광억소 C 화지련소수평적영향。방법장80례부합입조표준적조기당뇨병신병환자안수궤수자표법분위관찰조40례화대조조40례，량조균급여상규당뇨병종합간예방법，대조조재구복액패사탄150 mg／d，1차／d，관찰조재대조조적기출상재구복아탁벌타정20 mg／d，1차／d，량조환자균관찰12주，치료전후공복추혈검측공복혈당（FBG）、당화혈홍단백（HbA1c），신공능지표[혈기항（Sc）r、뇨소담（BUN）、뇨백단백배설솔（UAER）]，혈지지표[총담고순（TC）、감유삼지（TG）]，혈청광억소 C，지련소，채용24 h 동태혈압의감측 DBP、SBP。결과관찰조치료후 DBP、SBP、Scr、BUN、UAER、TC、TG、광억소 C、지련소균교치료전명현강저（P ＜0．05혹 P ＜0．01），단대조조치료전후 BUN、TC、TG 무명현변화（P ＞0．05），관찰조치료후 Scr、UAER、TC、TG、광억소 C、지련소명현저우대조조（P ＜0．05혹 P ＜0．01）。결론아탁벌타정연합액패사탄능구유효공제혈압，전면개선당지대사，유효강저지련소여혈청광억소 C，감소이도소저항，억제신소구공능수손，개선신공능，시방치조기당뇨병신병적량호방법。
Objective To observe the efficacy of atorvastatin and irbesartan in the treatment of early diabetic nephropathy and the influence on serum cystatin C and adiponectin,thus to improve clinical outcomes.Methods 80 patients with early diabetic nephropathy met the inclusion criteria were randomly divided into observation group (40 cases)and control group(40 cases).All patients were given conventional diabetes comprehensive intervention, the control group then was given irbesartan 150mg/d,qd,the observation group was given atorvastatin on the basis of control group,20mg/d,qd,both two groups were treated for 12 weeks.The FBG,HbA1c,renal function indication (Scr,BUN,UAER),lipid parameters indication(TC,TG),cystatin C,adiponectin were detected.DBP,SBP were detected by 24h ambulatory blood pressure.Results The DBP,SBP,Scr,BUN,UAER,TC,TG,cystatin C,adiponec-tin of the observation group after treatment were lower than before treatment(P <0.05 or P <0.01).The BUN,TC, TG of the control group had no significant changes before and after treatment (P >0.05).The DBP,SBP,Scr,BUN, UAER,TC,TG,cystatin C,adiponectin of the observation group after treatment were lower than the control group (P <0.05 or P <0.01).Conclusion Atorvastatin combined with irbesartan can effectively control blood pressure, has overall improvement in glucose and lipid metabolism,effectively reduce adiponectin,inhibit glomerular dysfunc-tion,improve kidney function,it is a good method for prevention and treatment of early diabetic nephropathy.