阿魏酸钠联合厄贝沙坦治疗糖尿病肾病临床观察

目的观察阿魏酸钠联合厄贝沙坦治疗糖尿病肾病的临床疗效。方法60例2型糖尿病肾病Ⅳ期患者随机分为两组，对照组予以控制血糖、降血脂的基础上，予以厄贝沙坦150mg／d，治疗组在对照组治疗基础上，加用阿魏酸钠注射液300mg／d×30d，静脉注射，比较两组患者治疗前后24h尿白蛋白定量、尿视黄醇结合蛋白（RBP）、尿β2-微球蛋白（β-MG）、尿血小板衍生生长因子（PDGF-BB）、血浆转化生长因子β（TGF-β）及肾功能的改变。结果两组肾功能、24h尿白蛋白定量均明显好转，两组间比较差异无统计学意义（P〉0．05）。治疗组肾小管功能指标RBP、β2-MG均显著降低，肾脏纤维化调节因子PDGF-BB、TGF-β均显著降低，与对照组比较差异有统计学意义（p〈0．05）。结论内皮素受体拮抗剂阿魏酸钠联合血管紧张素Ⅱ受体阻滞剂厄贝沙坦可以明显减少2型糖尿病肾病Ⅳ期患者蛋白尿，改善肾功能，延缓肾脏纤维化的进展。

The Clinical Observation on Type 2 Diabetic Nephropathy Treated with Sodium Ferulate and Irbesartan

Objective To investigate the protective effects of combination of sodium ferulate and irbesartan on type 2 diabetic nephropathy.Methods Sixty patients with type 2 diabetic nephropathy in phase Ⅳ were enrolled and randomly divided into the routine group （controlling the blood glucose, reducing blood lipids, meanwhile reducing the blood pressure and proteinuria with Irbesartan 150mg/d） and the treatment group （add Sodium Ferulate 300mg. d^-1 for 30 days）. The treatment lasted for 30 days, and the levels of all parameters as 24 hours quantity for urinary albumin, urinary RBP, β 2-MG, PDGF-BB, serum TGF-β, serum creatinine were measured before and after the treatment.Results The renal function and 24 hours quantity for urinary albumin in both groups were improved and reduced, but there was no statistical difference between these two groups.The levels of all parameters of renal tubular function, as urinary RBP, β2-MG, declined in the treatment group, moreover the levels of growth factors, as urinary PDGF-BB, serum TGF-β, also declined in the treatment group. Compared with the routine group, there were significant statistical differences （P〈0.05）.Conclusion The combination of sodium ferulate and irbesartan on type 2 diabetic nephropathy has significant protective effects for reducing proteinuria, delaying the process of renal failure and fibrosis.