缬沙坦联合胰激肽原酶治疗早期糖尿病肾病的疗效观察

目的观察缬沙坦联合胰激肽原酶治疗早期糖尿病肾病（DN）的临床疗效。方法90例早期DN患者随机分成3组，缬沙坦联合胰激肽原酶组、缬沙坦组及对照组各30例，观察6个月，比较治疗前后患者尿白蛋白排泄率（UAER）、尿β2-微球蛋白（β2-GM）、平均动脉压（MAP）、血清肌肝（Scr）及糖化血红蛋白（HbA1c）变化。结果治疗后缬沙坦联合胰激肽原酶组及缬沙坦组UAER及尿β2-MG较治疗前显著下降（P〈0．01），且较对照组显著下降（P〈0．01），缬沙坦联合胰激肽原酶组较缬沙坦组下降更为显著（P〈0．01），3组治疗后MAP较治疗前均有明显下降（P〈0．01），3组之间无统计学差异（P〉0．05）。结论缬沙坦联合胰激肽原酶治疗早期DN疗效确切，可有效减轻糖尿病肾病患者白蛋白尿。

The therapeutic effect of the combined kallidinogenase and valsartan on early stage of type 2 diabetic nephropathy

Objective To observe the therapeutic effect of the combined kallidinogenase and valsartan on early stage of type 2 diabetic nephropathy. Methods The 90 study subjects were randomly divided into three groups of observation group （valsartan plus kallidinagenase, n = 30）, ARB group （valsartan, n= 30）and control group（n= 30）. After 6 months of treatments the patients underwent examinations of urinary albumin excretion rate （UAER）, urine β2-microglobulin （β2-MG） , mean arterial blood pressure （MAP）, serum creatinine （Scr） and hemoglobin Alc （HbA1c）. Results The values of UAER and β2-MG had obviously decrease after treatment and were lower in observation and ARB group than was control group （P〈0. 01） and were lower in observation than in ARB group. The MAP of the three groups significantly decreased as compared to the baseline, with no differences among three groups （P〉0.05）. Conclusion The combined valsartan and kallidinogenase treatment have good effects in the treatment of early stage of type 2 diabetic nephropathy with lessening the abnormal urinary albumin.