水蛭素药物治疗尿微量白蛋白为主要表现的糖尿病肾病和高血压肾病的临床研究

目的探讨水蛭素药物对以尿微量白蛋白（UA）为主要表现的糖尿病肾病和高血压肾病患者的治疗作用。方法将尿微量白蛋白筛查均为阳性的糖尿病肾病和高血压肾病患者60例随机分为治疗A组、治疗B组及对照组,各20例。入选患者在血糖、血压控制治疗的同时,A组患者全程口服水蛭素药物脑血康;B组患者静脉输注水蛭素药物疏血通治疗15d后再口服脑血康治疗。治疗6个月后观察尿微量白蛋白的变化情况、血脂4项、凝血5项等疗效评价指标。结果 A组患者治疗1个月后尿微量白蛋白较治疗前有显著改善（P〈0.05）,B组患者治疗15d后尿微量白蛋白较治疗前有显著改善（P〈0.05）;A、B组患者凝血功能5项指标改善优于对照组（P〈0.05）;3组患者血脂4项指标均无明显变化（P〈0.05）;结论水蛭素有降低尿中微量白蛋白、改善高凝状况的作用,对糖尿病肾病和高血压肾病患者的肾脏有较好的保护作用。

Clinical study on hirudin in diabetic nephropathy with umalb as the main manifestations and hypertension kidney disease

Objective To discuss effect of hirudin in diabetic nephropathy with umalb（ UA） as the main manifestations and hypertension kidney disease. Methods 60 cases patients were randomly divided into treatment group A,treatment group B and control group,each of 20 cases. Selected patients in blood sugar,blood pressure control at the same time,group A treated with oral Naoxuekang,group B treated with oral Naoxuekang after intravenous infusion of Shuxietong for 15 days. After treatment of six m onths,observed index of effect evaluation of the changes of microalbuminuria,lipids 4 items,blood coagulation 5 items,etc. Results UA albumin after 1 month treatment was significantly improver than before treatment of group A （ P 0. 05） ,UA albumin after 15d treatment was significantly improver than before treatment of group B（ P 0. 05） ; Blood coagulation 5 items of group A and B were better than control group patients（ P 0. 05） ; Lipid 4 indexes of three groups had no obvious change（ P 0. 05）. Conclusion Hirudin known as the lower urine albumin,improve the effect of hypercoagulable state,has good protection for kidney of diabetic nephropathy and hypertension in patients with kidney disease.