低分子肝素联合ACEI/ARB治疗糖尿病肾病临床观察

目的：观察低分子肝素联合ACEI/ARB治疗糖尿病肾病（DN）的疗效。方法：将55例2型DN患者随机分为对照组（ACEI/ARB）和治疗组（ACEI/ARB＋低分子肝素）,疗程8周。比较两组治疗前和治疗后24h尿蛋白,Scr、BUN、血浆白蛋白等指标的变化。结果：（1）治疗后治疗组和对照组24h尿蛋白、Scr均显著下降（P〈0.01,P〈0.05）,治疗组比对照组下降更为明显（P〈0.05）。（2）治疗后两组血浆白蛋白均增加（P〈0.01）,治疗组与对照组治疗后比较无明显差异（P〉0.05）。（3）治疗后两组BUN均降低（P〈0.05）,治疗组与对照组治疗后比较无明显差异（P〉0.05）。（4）治疗后两组TC和TG均无明显变化。结论：联合应用低分子肝素能有效减少DN患者的蛋白尿,改善肾功能。

Clinical Observation on Low-Molecular-Weight Heparin with ACEI/ARB for Diabetic Nephropathy

Objective：To study the clinical effects of low-molecular-weight heparin （LMWH） and ACEI/ARB on diabetic nephropathy（DN）.Methods：55 patients of type 2 Diabetic nephropathy were randomly divided into treatment group（ACEI/ARB＋ LMWH）and control group （ACEI/ARB）.SCr,quantity of protein in 24-hour urine,BUN and plasma albumin figures were compared between two groups before treatment and eight weeks after treatment.Results：（1）SCr,quantity of protein in 24-hour urine had been decreased significantly in both groups（P〈0.01,P〈0.05）,and more significantly in treated group than in control group （P〈0.05）.（2）Plasma albumin increased significantly in both groups（P〈0.01）.But no significantly increase of plasma albumin had been found in treatment group during the follow-up（P〉0.05）.（3）BUN decreased significantly in both groups（P〈0.05）,but no significantly decrease of BUN had been found in treatment group during the follow-up（P〉0.05）.（4）There were no significantly difference in TC and TG between two groups.Conclusion：LMWH and ACEI/ARB can ameliorate proteinuria and improve renal function of the patients with DN.