内皮素拮抗剂阿魏酸钠联合奥美沙坦治疗早期糖尿病肾病的研究

目的：观察阿魏酸钠联合奥美沙坦治疗早期2型糖尿病肾病的效果。方法：100例2型糖尿病肾病Ⅲ期患者随机分为阿魏酸钠治疗组（以下称治疗组）和对照组。对照组予以控制血糖、降血脂等治疗,同时予以奥美沙坦40mg/d。治疗组在对照组治疗的基础上加用阿魏酸钠注射液300mg/d×30d,静脉注射。比较两组患者治疗前后24h尿白蛋白定量（24hUAlb）;血尿素氮（BUN）、血肌酐（Scr）;血内皮素-1（ET-1）、转化生长因子（TGF-β）;胆固醇（TC）、三酰甘油（TG）;尿视黄醇结合蛋白（RBP）、尿β2微球蛋白（β2-MG）的变化。结果：与治疗前比较,两组均明显好转;两组间比较差异有统计学意义（P〈0.05）;且治疗组效果更明显。结论：对于早期2型糖尿病肾病患者,内皮素受体拮抗剂阿魏酸钠联合奥美沙坦可以明显减少糖尿病肾病Ⅲ期患者蛋白尿,改善肾功能,延缓糖尿病肾病纤维化进程的进展,但仍需要进一步的大样本、多中心观察。

The Clinical Study on Early Type 2 Diabetic Kidney Disease Treated with Sodium Ferulate and Olmesartan

Objective：To investigate the protective effects of combination of sodium ferulate and olmesartan on early type 2 diabetic kidney disease.Methods：One hundred patients with type 2 diabetic nephropathy in phase Ⅲwere enrolled and randomly divided into the control group（controlling the blood glucose,reducing blood lipids,meanwhile reducing the blood pressure and proteinuria with olmesartan 40 mg/d） and the treatment group（add Sodium Ferulate 300 mg/d for 30 days）.The treatment lasted for 30 days,and the levels of all parameters asserum ET-1,serum creatinine、BUN,serum TG、TC,24 hours quantity for urinary albumin,urinary RBP,β2-MG were measured before and after the therapy.Results：The serum Creatinine、 BUN、ET-1、TGF-β,24 h UALB;serum TC、TG;urinaryβ 2-MG;RBP in both groups were improved.and there was statistical difference between these two groups.The levels of all parameters of renal tubular function,as urinary RBP,β2-MG,declined in the treatment group.Compared with the control group,there were significant statistical differences（P0.05）.Conclusion：The combination of sodium ferulate and olmesartan on early type 2 diabetic kidney disease has significant protective effects for reducing proteinuria,delaying the process of renal disease;however,more evidences will be needed.