厄贝沙坦联合雷公藤多甙对高原地区糖尿病肾病患者尿蛋白的影响

目的 观察厄贝沙坦联合雷公藤多甙对高原地区糖尿病肾病(DN)患者尿蛋白水平的影响.方法 将50例高原DN患者随机分为两组,对照组(25例)给予厄贝沙坦150 mg口服,治疗组(25例)在厄贝沙坦口服的基础上加用雷公藤多甙40 mg口服,疗程为3个月.观察患者治疗前、后24h尿蛋白定量、动脉压及肝、肾功能指标的变化.结果 治疗组24 h尿蛋白由治疗前(8.34±1.29)g降低到治疗后(6.42 ±0.95)g,差异有统计学意义(t=5.994,P＜0.001).对照组24 h尿蛋白由治疗前(8.57±0.53)g降低到治疗后(7.10±0.79)g,差异有统计学意义(t=7.730,P＜0.001).治疗组治疗前收缩压为( 152.04±18.80)mm Hg,治疗后降低到(131.24±10.56) mm Hg,差异有统计学意义(t=4.817,P＜0.001)；舒张压治疗前(93.60±11.36) mm Hg,治疗后降低到(82.68±7.30) mm Hg,差异有统计学意义(t =4.053,P＜0.001).对照组治疗前收缩压为(151.20±10.17) mm Hg,治疗后降低到(130.00±10.10)mm Hg,差异有统计学意义(t=7.396,P＜0.001)；舒张压治疗前(92.76±7.03)mm Hg,治疗后降低到( 84.20±7.56) mm Hg,差异有统计学意义(t=4.147,P＜0.001).两组治疗前后肝、肾功能差异均无统计学意义(P均＞0.05).结论 厄贝沙坦联合雷公藤多甙可在一定程度上降低高原地区DN患者的尿蛋白水平.

Effect of Irbesartan and Triptolide combination on the level of urine protein in patients with diabetic nephropathy at high altitude area

Objective To observe the effect of irbesartan and triptolide combination on the level of urine protein in patients with diabetic nephropathy at high altitude area. Methods Fifty patients with diabetic nephropathy （24-hour urine protein excretion over 1.0 g and serum creatinine level below 265.2 mol/L） at high altitude area were randomly divided into two groups ,the control group were treated with irbesartan 150 mg/d for three months, and the treatment group received irbesartan 150 mg/d combined with triptolide 40 mg/d for three months. 24-hour urine protein concentration , arterial pressure, liver function and renal function were measured before and after the treatment. Results After three months＇ treatment, the levels of 24-hour urine protein and arterial pressure were significantly lower in both control and treatment group（ P 〈 0.01 ）. Twenty-four hour urine protein in treatment group were reduced from （ 8.34 ＋ 1.29） g before treatment to （6. 42 ＋ 0. 95 ） g after treatment（ t = 5. 994, P 〈 0. 001 ）. Twenty four-hour urine protein in control group were reduced from （8. 57 ＋0. 53）g before treatment to （7.10_＋0. 79）g after treatment（t =7. 730,P 〈0. 001 ）. Systolic pressure in treatment group were reduced from （ 152. 04 ＋ 18.80）mm Hg before treatment to （ 131.24 ＋ 10. 56）mm Hg after treatment（t = 4. 817, P 〈 0. 001 ） ; Diastolic pressure in treatment group was reduced from （ 93.60 ＋ 11.36 ） mm Hg before treatment to （ 82. 68 ＋ 7.30） mm Hg after treatment （ t = 4. 053, P 〈 O. 001 ）. Systolic pressure in control group were reduced from （ 151.20 ＋ 10. 17 ） mm Hg before treatment to （ 130. 00 ＋ 10. 10） mm Hg after treatment（t = 7. 396, P 〈 0. 001 ） ; Diastolic pressure in treatment group were reduced from （92. 76 ＋ 7. 03 ） mm Hg before treatment to （ 84. 20 ＋ 7. 56） mmHg after treatment （ t = 4. 147, P 〈 0. 01 ）. No statistic differences were observed in liver function and renal function before and after the treatment （ P 〉 0. 01 ）. Conclusion Irbesartan and triptolide combination can reduce 24-hour urine protein to a certain extent and donot adversely affect liver function and renal function in patients with diabetic nephropathy at high altitude area