替米沙坦联合螺内酯对早期糖尿病肾病微量自蛋白尿和血清C反应蛋白的影响

目的观察替米沙坦联合螺内酯对糖尿病肾病的疗效以及微量白蛋白和C反应蛋白（CRP）的影响。方法采用随机对照方法将人选的早期糖尿病。肾病患者60例随机分成替米沙坦联合螺内酯治疗组（观察组）和单用替米沙坦治疗组（对照组），各30例。治疗12周后观察微量白蛋白排泄率、CRP以及其他生化指标。结果两组患者治疗前后空腹血糖（FBG）、糖化血红蛋白（HbA_1c）、血清钾（K）、血肌酐（Scr）等指标比较，差异无统计学意义（P〉0．05），观察组各指标与对照组治疗后相比，差异无统计学意义（P〉0．05）；治疗后两组尿微量白蛋白排泄率（UAER）和CRP水平明显降低，差异有统计学意义（P〈0．05），且观察组比对照组降低更明显（P〈0．05）；两组患者不良反应发生率比较差异无统计学意义（P〉0．05）。结论替米沙坦联合螺内酯治疗早期糖尿病肾病疗效确切，可有效地降低其尿微量白蛋白和CRP水平，改善患者预后。

Effect of Telmisartan combined with Spironolactone on microalbuminuria and serum C-reactive protein in early diabetic nephropathy

Objective To observe the effect of Telmisartan combined with Spironolactone on microalbuminuria and C- reactive protein （CRP） in diabetic nephropathy. Methods 60 cases with early diabetic nephropathy were randomly di- vided into Telmisartan Spironolactone therapy group （observation group） and Telmisartan therapy group （control group）, with 30 cases in each group. The albumin excretion rate, CRP and other biochemical markers were observed after 12 weeks of treatment. Results Before and after treatment, the level in the two groups of patients of FBG, HbA,~, K, Scr indexes were not statistically significant （P 〉 0.05）, and the level of each index after treatment in the observation group and the control group was not statistically significant different （P 〉 0.05）; the level of UAER and CRP was significant- ly lower after treatment, the differences were statistically significant （P 〈 0.05）, and the observation group decreased significantly than the control group （P 〈 0.05）; the incidence of adverse reactions of the two groups was not significant different （P 〉 0.05）. Conclusion Telmisartan combined Spironolactone is effective to early diabetic nephropathy, can effectively reduce the level of urinary albumin and CRP, improve the outcomes of patients.