替米沙坦对糖尿病肾病患者超敏C反应蛋白及胱抑素的影响

目的：观察替米沙坦在治疗早期糖尿病肾病（DN）中，对超敏C反应蛋白（hsCRP）及胱抑素（CysC）水平的影响。方法：收集本院门诊85例早期DN患者随机分为治疗组（45例）和对照组（40例）。治疗组使用替米沙坦治疗，对照组予尼群地平，两组均给予胰岛素控制血糖，进行12周临床观察，比较两组血压、血脂、血糖、糖化血红蛋白（HbA1c）、尿微量白蛋白排泄率（UAER）、hsCRP及Cys C的变化。结果：两组在治疗前各项指标无明显差异（P〉0．05）；经过12周的治疗，两组UAER、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、空腹血糖（FBG）、餐后2h血糖（2hPG）、HbA1c、hsCRP、CysC和血压较治疗前均有明显好转（P〈0．01）；而治疗组的UAER、TC、HDL-C、LDL-C、hsCRP及CysC较对照组改善更明显（P〈0．05）。结论：替米沙坦治疗早期DN，能有效改善hsCRP、CysC及减少UAER，可能对延缓早期糖尿病肾病的进展有益。

The Effects of Telmisartan on High Sensitivity CRP and Cys C in Patients with Early Diabetic Nephropathy

Objective： To evaluate the effects of Telmisartan on the levels of high sensitivity C-reactive protein （hsCRP） and serum cystatin C （Cys C） in patients with early diabetic nephropathy （DN）. Methods： Eighty-five patients with early DN were randomly assigned to the control group （n=40） treated on nitrendipine or the intervention group （n= 45） treated on telmisartan, while receiving concomitant regular insulin, for 12 weeks. Changes before and after treatment in levels of blood pressure, serum lipids, plasma glucose, HbA.c, urine albumin excretion rate （UAER）, hsCRP and Cys C were observed and compared between the two groups. Results：The two groups showed similar levels of the indexes at baseline （P〉0.05）. After 12 weeks of treatment, UAER, serum TC, TG, HDL-C, LDL-C, fasting blood sugar, 2 h postprandial blood sugar, HbA.c, hsCRP, Cys C and blood pressure were significantly improved in both groups （P〈0.01）. The intervention group showed greater improvement in UAER, TC, HDL-C, LDL-C, hsCRP and Cys C （P〈0.05 or P〈0.01） compared with the controls. Conclusion： Use of telmisartan in the treatment of early diabetic nephropathy can decrease the levels of hsCRP, Cys C and microalbuminuria, and may show promises for delaying the progression of early diabetic： nephropathy.