依普利酮对糖尿病肾病患者微血管病变及尿蛋白含量的影响

[目的]探讨依普利酮治疗糖尿病肾病患者的疗效及对微血管病变及尿蛋白含量影响.[方法]选择本院2013年1月至2014年10月期间收治83例糖尿病肾病患者作为研究对象,采用随机数字表法分为观察组(n=42)与对照组(n=41).对照组应用螺内酯治疗,观察组用依普利酮治疗,比较两组治疗前后24 h尿蛋白、尿微量白蛋白(uAlb)、尿免疫球蛋白G(uIgG)、血浆层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)水平变化.[结果]两组治疗前24 h尿蛋白,uAlb与uIgG及LN、PCⅢ与CⅣ水平相比较差异均无显著性(P>0.05),治疗后各项指标均降低,组内前后相比较差异有显著性(P<0.05).同时观察组各项指标治疗后比对照组改善幅度更大,且两组间相比较差异有显著性(P<0.05).[结论]依普利酮为新型选择性醛固酮拮抗剂,在糖尿病肾病患者中应用可显著降低患者尿蛋白量并改善微血管病变,同时抑制并逆转肾脏纤维化,其效果理想,值得借鉴推广.

Effect of Eplerenone on Microvascular Lesions and the Content of Urine Protein in Patients with Diabetic Nephropathy

[Objective]To explore the curative effect of eplerenone on the treatment of diabetic nephropathy and effect on microvascular lesions and content of urinary protein.[Methods]83 cases of patients with diabetic ne-phropathy treated in our hospital from January 2013 to October 2014 were selected as the research objects,and were randomly divided into the observation group (n =42)and the control group (n =41).The control group was treated by spironolactone while the observation group was treated with eplerenone.The levels of serum potas-sium,urine protein,microvascular lesions (uAlb,uIgG),and renal fibrosis (LN,PCⅢ,CⅣ),were compared between the two groups 24 hours before and after the treatment.[Results]Before the treatment,the differences in UMA and urine protein between the two groups were not statistically significant (P >0.05).However,after the treatment,the 2 indexes decreased and the before and after differences within group were statistically significant (P <0.05).In addition,the above indexes of the observation group after the treatment were lower than those of the control group (P <0.05).The differences in uAlb and uIgG between the two groups before the treatment were not statistically significant (P >0.05).After the treatment,the 2 indexes decreased and the before and after differences within group were statistically significant (P <0.05).Meanwhile,uAlb and uIgG of the observation group were lower than those of the control group (P <0.05),which indicated that the improvement of microvas-cular lesions in the observation group was more significant.[Conclusion]Eplerenone is a new type selective aldoste-rone antagonist.Its application in patients with diabetic nephropathy can significantly reduce urine protein and im-prove microvascular lesions.It can inhibit and reverse renal fibrosis at the same time and the effect is ideal.It is worth learning and promoting.