安体舒通对1型糖尿病肾病患者尿微量白蛋白的影响

目的 观察安体舒通对1型糖尿病患者尿微量白蛋白的影响.方法 将我院42例早期1型糖尿病肾病患者随机分为对照组（23例）和安体舒通治疗组（19例）,对照组采用常规治疗,治疗组在常规治疗的基础上加用安体舒通（20 mg/d,qd）,两组疗程均为12周.检测患者治疗前后尿微量白蛋白排泄率（UAER）、血肌酐（Scr）等,记录患者不良反应.结果 对照组随着基础治疗时间的延长,8周末UAER [（59.92±2.01）μg/min]与治疗前[（101.75±1.98） μg/min]比较明显降低（P＜0.05）.安体舒通治疗组8周治疗后UAER [（21.92±1.52） μg/min]与治疗前[（104.07±2.06） μg/min]比较显著减少（P＜0.01）;其与对照组比较差异仍有统计学意义（P＜0.05）.安体舒通治疗组和对照组患者Scr水平治疗前后差异无统计学意义（P＞0.05）,且无不良反应.结论 在常规治疗糖尿病肾病的基础上加用安体舒通能进一步降低UAER,延缓肾脏损伤,对肾功能起到保护作用.

Effects of sprionolactone on urinary microalbumin in patients with type 1 diabetic nephropathy

Objective To observe the effect of sprionolactone on urinary microalbumin in patients with type 1 diabetic nephropathy.Methods Forty-two patients with diabetic nephropathy were randomly divided into two groups.The control group （n=23） received conventional treatment,while sprionolactone treatment group （n=19） was given 20 mg/d sprionolactone （qd） based on conventional treatment.The treatment course was 8 weeks.The levels of urinary albumin excretive rate （UAER）,Scr and adverse drug reactions of the two groups were observed.Results In the control group,the UAER after treatment [（59.92±2.01） μg/min] was significantly reduced,compared with that before treatment [（101.75±1.98） μg/min,P＜0.05.The UAER in sprionolactone treatment group was lowered more significantly after treatment [（21.92±1.52） μg/min vs （104.07±2.06） μg/min; P＜0.01],showing statistically significant difference with the control group [（21.92± 1.52） μg/min vs （59.92±2.01） μg/min; P＜0.05].The Scr level of the control group and sprionolactone treatment group showed no significant difference before and after treatment （P＞0.05）,and no adverse reactions were found.Conclusion Spironolactone based on conventional treatments can offer additional renoprotection in patients with diabetic nephropathy,further reduce the urinary albumin excretive rate,and protect the kidney function.