布美他尼治疗老年2型糖尿病中晚期肾病的临床疗效观察

目的：观察布美他尼（Bumetanide）治疗老年2型糖尿病中晚期糖尿病肾病（diabetic nephropathy， DN）的临床疗效．方法选取老年2型糖尿病中晚期肾病40例，在基础治疗（控制饮食、运动，控制血压、血糖）上，随机分为对照组和治疗组各20例，对照组口服呋塞米，治疗组口服布美他尼并跟踪随访3个月，评估治疗前后转铁蛋白（TRF）和尿微量白蛋白并进行比较．结果（1）治疗组患者治疗前与治疗后尿素氮（BUN）、血肌酐（SCr）、尿酸（UA）有所降低，2组患者变化无统计学差异（P＞0.05）；对照组患者治疗后尿素氮（BUN）、血肌酐（SCr）、尿酸（UA）有所降低，2组患者变化无统计学差异（P＞0.05）．治疗组与对照组之间也无统计学差异（P＞0.05）；（2）40例老年DN患者治疗1周后治疗组较对照组尿微量白蛋白和尿转铁蛋白测定值较前减低，但2组患者变化无统计学差异（P＞0.05）．随着治疗时间延长至4周，8周，12周，布美他尼组较呋塞米组尿微量白蛋白和尿转铁蛋白测定值较前明显减低，且差异有统计学意义（P＜0.05）．结论布美他尼治疗老年2型糖尿病中晚期肾病的疗效优于呋塞米．

Clinical Curative Effect Observation of Bumetanide on Elderly Type 2 Diabetic Patients with Middle and Advanced Stages Nephropathy

Objective The purpose of this study was to observe the effects of bumetanide on elderly type 2 diabetic patients with middle and advanced stages nephropathy. Methods Forty cases with diabetic nephropathy （DN） were divided into two groups：control group （20 cases） and treatment group （20 cases） . The control group accepted furosemide （20 mg, once a day） and the bumetanide was orally administrated at the dose of 1.0 mg, twice a day to the treatment group for 3 months. The assessment of transferrin （TRF） and urine microalbumin （UALB） was performed at the time points at the end of 1, 4, 8, 12 weeks after treatment. Results （1） The levels of BUN, SCr and UA after treatment were lower than before treatment, but there were no significant differences. （2） In the treatment group, the levels of TRF and UALB have decreased after treatment for 1 week, with no statistically significant. But at the end of 4, 8 and 12 weeks,the differences were statistically significant （P〈0.05） . Especially, during the three months follow-up,the levels of TRF and UALB at 12 weeks have decreased obviously. Conclusion The therapeutic effect of bumetanide on DN might be better than that of furosemide.