缬沙坦联合胰激肽原酶治疗早期糖尿病肾病的临床评价

目的探讨血管紧张素Ⅱ受体拮抗剂缬沙坦与胰激肽原酶联合治疗早期糖尿病肾病的临床疗效.方法 2008年6月至2009年12月曲靖市第二人民医院内科住院治疗的早期2型糖尿病合并糖尿病肾病患者40例,随机分为对照组和观察组各20例,在常规治疗的基础上,对照组患者给予常规降血糖及血管紧张素Ⅱ受体拮抗剂缬沙坦治疗,观察组患者在对照组治疗的基础上加用胰激肽原酶治疗.结果观察组经治疗后24 h尿微量白蛋白（UAE）有明显下降,与对照组相比差异有统计学意义（P〈0.05）.两组间肌酐和尿素氮变化差异无统计学意义（P〉0.05）.结论血管紧张素Ⅱ受体拮抗剂缬沙坦联合胰激肽原酶能明显减少早期糖尿病肾病患者的尿蛋白,延缓糖尿病肾病的发展,作用安全有效,值得临床推广应用.

Clinical Evaluation on the Treatment of Early Diabetic Nephropathy by Valsartan Combined with Kallidinogenase

Objective To investigate the effect of angiotensinⅡreceptor antagonist valsartan combined with kallidinogenase on early diabetic nephropathy.Methods Forty of early type II diabetic nephropathy patients,hospitalized in our department between June 2008 and December 2009,were randomly divided into control and treatment group（n=20 for each group）.The patients in the control group were treated with regular therapy（antidiabetic drug and valsartan）;the patients in the treatment group were treated with the regular therapy combined with kallidinogenase.Results Urine albumin excretion（UAE）at 24 h following treatment was markedly decreased in the treatment group compared to the control group（P0.05）.However,the changes in creatinine and urea nitrogen had no significant difference between the two groups（P0.05）.Conclusions AngiotensinⅡreceptor antagonist valsartan combined with kallidinogenase can reduce obviously urine protein in type II diabetic nephropathy patients and delay the development of its pathological process.The combination therapy is thus safe and effective and can be employed in clinical practice.