摘要
目的：探讨阿法骨化醇联合氯沙坦钾片治疗早期糖尿病肾病的临床疗效。方法选取90例早期糖尿病肾病患者，将其按照随机数字表法分为观察组和对照组，每组45例。对照组给予氯沙坦钾片进行治疗，观察组给予阿法骨化醇联合氯沙坦钾片进行治疗，两组均治疗3个月。观察两组治疗前后空腹血糖（FBG）、24 h 尿微量白蛋白定量（UAER）、24 h 尿蛋白定量（24 h pro）、血肌酐（Scr）、25-羟维生素 D （25（OH）D）、血钙（Ca2＋）、血钾（K＋）、糖化血红蛋白（HbA1 c ）指标及血清炎性因子指标[C 反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）]水平，并对25（OH）D与UAER、24 h pro的相关性进行分析。同时对治疗后的临床疗效和治疗期间的不良反应进行评估。结果观察组总有效率为93．3％，显著高于对照组的71．1％（χ2＝7．601，P＜0．05）；治疗后两组FBG、HbA1c、血Ca2＋、血K＋均无显著变化（均P＞0．05）；治疗后两组Scr、24 h pro、UAER均较治疗前显著下降（均P＜0．05），但观察组治疗后24 h pro、UAER低于对照组（t＝6．296、11．530，均P＜0．05），两组治疗后Scr相比差异无统计学意义（t＝0．331，P＞0.05）；治疗后观察组25（OH）D较治疗前显著下降（t＝12．000，P＜0．05），且显著高于对照组治疗后（t＝11.278，P＜0．05），与治疗前相比，对照组治疗后25（OH）D无显著变化（t＝0．436，P＞0．05）。Pearson相关性分析显示，25（OH）D水平与24h pro、UAER呈负相关（r＝－0.483、－0．778，均P＜0．05）。治疗后两组CRP、TNF-α、IL-6均较治疗前显著下降（均P＜0．05），但观察组下降更明显（均P＜0.05）。两组均未发现严重不良反应，两组不良反应发生情况差异无统计学意义（χ2＝0．212，P＞0．05）。结论阿法骨化醇联合氯沙坦钾片可显著降低早期糖尿�
Objective To discuss the curative effects of alfacalcidol combined with losartan potassium tablets in the treatment of early diabetic nephropathy （EDN）.Methods 90 EDN patients in our hospital were chosen and randomly divided into the observation group and control group （45 cases in each group）.The control group was given losartan potassium tablets treatment,while the observation group was given alfacalcidol combiend with telmisartan treatment.All the two groups were treated for 3 months.Before and after treatment,the fasting blood glucose （FBG）, 24h urine trace albumin quantitative （UAER）,24h urine protein （24h pro）,serum creatinine （SCr）,25 -hydroxyl vitamin D [2 5 （OH ）D ],blood calcium （Ca2＋）,potassium （K＋）,glycosylated hemoglobin （HbA 1 C ）and serum＆amp;nbsp;inflammatory factors[C-reactive protein （CRP）,tumor necrosis factor alpha （TNF-α）,interleukin-6 （IL-6 ）] were observed,and the correlation between 25 （OH）D and UAER,24h pro was analyzed.At the same time,the clinical curative effects and adverse reactions during treatment were evaluated.Results In the observation group,the total effective rate was 93.3%,which was significantly higher than 71.1% in the control group （χ2 =7.601,P〈0.05）.In the two groups after treatment,the FBG,HbA1c,blood Ca2＋and K＋had no significant changes （all P〉0.05）.After treatment,Scr,24h pro and UAER in the two groups were all significantly reduced compared with before treatment （P〈0.05）,and 24h pro and UAER in the observation group were significantly lower than those in the control group （t=6.296,11.530,all P〈0.05）,but Scr had no statistically significant difference between two groups （t=0.331,P〉0.331）.After treatment,25（OH）D in the observation group decreased significantly compared with before treatment （t=12.000,P〈0.05）,which was significantly higher than that in the control group after treatment （t=11.278,P〈0.05）.Compared with before treatment,25（OH）D in the contro
出处
《中国基层医药》
CAS
2017年第3期391-395,共5页
Chinese Journal of Primary Medicine and Pharmacy
关键词
早期糖尿病肾病
阿法骨化醇
氯沙坦钾片
Early diabetic nephropathy
Alfacalcidol
Losartan potassium tablets
