摘要
目的观察低分子肝素联合氯沙坦治疗糖尿病肾病(DN)的疗效。方法 DN患者70例分为氯沙坦组(30例)和低分子肝素组(40例),两组均给予糖尿病治疗方案及氯沙坦50 mg/d口服,低分子肝素组加用低分子肝素6000 IU皮下注射,1次/天,治疗的第2和第4周分别比较两组治疗前后的血压、24 h尿蛋白定量(24 h-MTP)、血肌酐(Scr)、血脂、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)等指标的变化,同时观察常见并发症发生情况。结果氯沙坦组治疗2、4周后血压明显改善,治疗4周后24 h-MTP明显下降(P<0.05)。低分子肝素组治疗2、4周后24 h-MTP、Scr、FIB下降,血压明显改善,APTT延长(P<0.05),且24 h-MTP、Scr、FIB均低于氯沙坦组,APTT长于氯沙坦组(P<0.05)。两组无出血、低血压等并发症发生。结论低分子肝素联合氯沙坦可明显降低早期DN患者24 h小时尿蛋白和改善肾功能,具有保护肾功能的作用,且安全性较好。
Objective To observe the effects of combination of losartan and low molecular weight heparin in the treatment of diabetic nephropathy （DN）. Methods Seventy DN patients were divided into control group （ n = 30） and experimental group （ n = 40）. The two groups were all given diabetic therapeutic regimen and losartan（50 mg/d）. The experimental group was further given low molecular weight heparin（ subcutaneous injection, 1 time/d, and 6000U/d）. The period of observation was 4 weeks. The levels of 24 h urine protein, serum creatinine （ Cr）, blood lipid, fibrinogen （ FIB ）, activated partial thromboplastin time （AprIT） and serum albumin （ALB） were compared at the time of 0,2 and 4 weeks after the treatments between the two groups. At the same time, the side-effects were also compared. Results In the control group, the levels of 24 h urine protein decreased significantly after 4 weeks of treatment when compared to the 0 week. In the experimental group, the levels of the 24 h urine protein and serum Cr began to decrease significant- ly after 2 weeks of therapy and this situation was more obvious after 4 weeks of therapy （ P 〈 0. 05 ）. The blood pressure of the two groups was improved dramatically during the 4 weeks of treatment（P 〈 0. 05）. It is worth mentioning that 24 h urine protein, Scr and the value of FIB in the experimental group was lower than that in the control group（ P 〈 0. 05 ） while the level of APTY in the experimental group was greater than that in the control group （ P 〈 0. 05 ）. Referring to the complication, no bleeding and hypetension occurred. Conclusion The application of combination of low molecular weight heparin and losartan could significantly decrease the 24 h urine protein and improve the kidney function in the treatment of DN.
出处
《实用医院临床杂志》
2015年第5期177-179,共3页
Practical Journal of Clinical Medicine
关键词
低分子肝素
糖尿病肾病
氯沙坦
蛋白尿
Low molecular weight heparin
Diabetic nephropathy
Losartan
Proteinnuria
