来氟米特联合氯沙坦钾对糖尿病肾病患者肾小球足细胞的影响

目的 探讨来氟米特联合氯沙坦钾对糖尿病肾病（DN）患者肾小球足细胞的影响。方法 将60例DN患者随机分为对照组与治疗组各30例,对照组予氯沙坦钾治疗,50 mg/次口服,1次/d;治疗组在对照组基础上给予来氟米特治疗,前3 d剂量为50 mg/次,1次/d,之后减量至20 mg/次,1次/d。两组疗程均为6周。分别在治疗前后检测血肌酐（Scr）、尿素氮（BUN）、24 h蛋白尿定量、尿足细胞数及其标志蛋白（PCX）。结果 治疗前,两组Scr、BUN、24 h蛋白尿定量均无统计学差异;治疗后,两组Scr、BUN、24 h蛋白尿定量均较治疗前明显下降,同组治疗前后比较差异有统计学意义（P<0.05）;且治疗组以上指标明显低于对照组,差异有统计学意义（P<0.05）。治疗前,两组尿足细胞数和PCX水平比较,差异无统计学意义;治疗后,两组尿足细胞数和PCX水平较治疗前明显降低,同组治疗前后比较差异有统计学意义（P<0.05）;且治疗组明显低于对照组,差异有统计学意义（P<0.05）。治疗组总有效率为93.3%,明显优于对照组的73.3%,差异有统计学意义（P<0.05）。结论 来氟米特联合氯沙坦钾治疗DN的疗效较好,可有效减少肾小球足细胞的损伤。

Effect of losartan potassium combined with leflunomide on glomerular podocyte in patients with DN

Objective To investigate the effect of losartan potassium combined with leflunomide on glomerular podocyte in patients with DN.Methods 60 patients with DN were randomly divided into the control group and the treatment group with 30 cases in each group. The control group were treated with losartan potassium, and the treatment group were treated with losartan potassium combined with leflunomide. Serum creatinine (Scr), urea nitrogen (BUN), 24 h protein, urine podocyte number and its marker protein (PCX) were measured before and after treatment.Results The levels of Scr, BUN, 24 h, proteinuria, urine podocytes and PCX in the two groups were significantly lower than those before treatment (P < 0.05), and the treatment group were significantly lower than those of the control group (P < 0.05). The clinical curative effect of the treatment group was obviously superior to that of the control group (P < 0.05).Conclusions Losartan potassium combined with leflunomide is effective in the treatment of DN, and can effectively reduce the podocyte damage.