骨化三醇联合厄贝沙坦治疗早期糖尿病肾病的临床观察

目的分析骨化三醇联合厄贝沙坦治疗早期糖尿病肾病(DN)的临床效果。方法选取2012年2月至2013年2月宝鸡市人民医院收治的早期DN患者68例作为研究对象,根据治疗方法将患者分为厄贝沙坦组和联合治疗组,患者分别给予单纯厄贝沙坦及骨化三醇联合厄贝沙坦治疗,比较两组患者的治疗效果、血清肌酐、肌酐清除率、24 h蛋白尿定量及炎性因子水平。结果联合治疗组的疗效及肌酐清除率均显著高于厄贝沙坦组(97.06%vs 82.35%)及(84.21±7.49)mL/min vs(61.83±7.94)mL/min](P<0.05);血清肌酐及24 h尿蛋白定量显著少于厄贝沙坦组(91.65±9.46)μmol/L vs(158.43±14.82)μmol/L]及(103.27±32.14)mg/24 h vs(186.32±43.27)mg/24 h](P<0.05);炎性因子的水平均显著低于厄贝沙坦组(P<0.05)。结论骨化三醇联合厄贝沙坦可有效提高早期DN患者的治疗效果,降低了血肌酐,提高了肌酐清除率,减少了24 h蛋白尿,同时降低了炎性因子水平。

Clinical Observation on Calcitriol Combined with Irbesartan in the Treatment for Early Diabetic Nephropathy

Objective To analyze the clinical effect of calcitriol combined with irbesartan in the treatment for early diabetic nephropathy（DN）. Methods A total of 68 cases of patients with early DN admitted in Baoji People＇s Hospital from Feb. 2012 to Feb. 2013 were selected as objects, according to the treatment methods, the patients were divided into irbesartan group （treated only with irbesartan） and combination group （treated with caleitriol and irbesartan）. The curative effect, serum creatinine, ereatinine clearance rate,24 h proteinuria quantity and inflammatory factors＇ levels of the two groups were compared. Results The curative effect and creatinine clearance rate of the combination group were significantly higher than those of the irbesartan group（ 97. 06% vs 82. 35% ） and （ 84.21 ± 7. 49 ） mL/min vs （ 61. 83 ± 7. 94 ） mL/min （ P 〈 0.05 ） ; the levels of serum creatinine and 24 h urine protein quantity of the combination group were significantly less than those of the irbesartan group （91.65 ± 9.46） μmol/L vs （158.43 ± 14.82） μmol/L] or （ 103.27 ± 32. 14 ） mg/24 h vs （ 186.32 ± 43.27 ） rag/24 h ] （ P 〈0.05 ） ; the inflammatory factors＇ levels of the combination group were significantly lower than those of the irbesartan group （ P 〈 0.05 ）. Conclusion Calcitriol combined with irbesartan therapy can improve the treatment effectiveness of early diabetic nephropathy, which includes reducing the serum ereatinine and 24 h proteinufia, increasing the creatinine clearance rate, and lower the inflammatory factors＇ levels.