螺内酯联合厄贝沙坦对早期糖尿病肾病患者微量清蛋白尿影响

目的通过观察螺内酯联合厄贝沙坦与单用厄贝沙坦治疗早期糖尿病肾病患者微量清蛋白尿的疗效比较,探索醛固酮受体拮抗剂联合血管紧张素Ⅱ受体拮抗剂在治疗早期糖尿病肾病中的价值。方法2007年4~9月本院接受治疗的早期糖尿病肾病患者28例,随机分为厄贝沙坦组、螺内酯联合厄贝沙坦组进行12周治疗。检测尿微量清蛋白排泄率(UAER)、醛固酮(ALD)、C反应蛋白(CRP)、血钾等的变化并进行分析。结果两组均能减少患者尿微量清蛋白排泄率,改善内生肌酐清除率、血脂、C反应蛋白水平。而螺内酯联合厄贝沙坦组较单用厄贝沙坦治疗组改善更为明显,且有统计学意义。结论使用螺内酯联合厄贝沙坦比单用厄贝沙坦对控制早期糖尿病肾病微量清蛋白尿更有效。

Combined therapy of aldactone and irbesartan in earlier period type 2 diabetic patients with overt album inuria

Objective To investigate the combined therapy of aldactone and irbesartan in earlier period type 2 diabetic patients with overt album inuria,and compare the effectiveness with irbesartan alone.Methods 28 patients were involved in this study.The 2 groups of patients were administered of combined therapy of aldactone and irbesartan and irbesartan alone.The levels of urinary albumin excretion rate (UAER),aldosterone (ALD),C-reactive protein(CRP),were measured at the beginning and the end of research.Results There were significant changes on level of UAER,ALD,CRP after 12 weeks before and after treatment.The better curative effect was observed in group which accepted both aldactone and irbesartan.Conclusion Combined therapy of aldactone and irbesartan in earlier period type 2 diabetic patients with overt album inuria is superior to use irbesartan alone and no apparent side effect was observed.