伟素治疗微量白蛋白尿期糖尿病肾病的疗效  

A Randomized Controlled Trial of Sulodexide for Early Diabetic Nephropathy

作　　者：陈思娇[1] 魏敏[1] 高阳[1] 胡怡[1] 熊盈[1] 张绍维[2] 时景璞[3] 李廷富[1] 宋今丹[4] 

机构地区：[1]中国医科大学附属第一医院老年医学研究室,沈阳110001 [2]中国人民解放军202医院内分泌肾内科,沈阳110001 [3]中国医科大学附属第一医院流行病学教研室,沈阳110001 [4]中国医科大学医学分子生物学研究所卫生部细胞生物学重点实验室,沈阳110001

出　　处：《中国循证医学杂志》2008年第3期162-166,共5页Chinese Journal of Evidence-based Medicine

基　　金：沈阳市科学技术计划项目(1071162-9-00);辽宁省科技攻关项目(2007225004-3);辽宁省自然科学基金项目(20062102)

摘　　要：目的探讨伟素对微量白蛋白尿期糖尿病肾病的疗效。方法纳入年龄43～70岁,糖尿病病程6个月～30年,24h尿白蛋白排泄率(UAER)30～300mg的60例。微量白蛋白尿期糖尿病肾病(DN)患者60例,采用计算机随机分组方法将患者等分为3组:常规治疗组只予常规降糖治疗12周;氯沙坦钾组在常规降糖治疗同时每日晨口服氯沙坦钾50mg,12周;伟素组在常规降糖治疗的同时给予伟素600LSU,qd,iv或im治疗4周,再以250 LSU bid,po序贯治疗8周。所检测指标包括尿白蛋白排泄率(UAER)、尿素氮(BUN)、肌酐(Cr)等。结果常规治疗组UAER在治疗前后差异无统计学意义(P>0.05)。而氯沙坦钾组和伟素组两组治疗前后差异有统计学意义(P<0.01),治疗3个月后氯沙坦钾组UAER下降34.04%,伟素组下降33.62%。治疗后两组UAER与常规组比较差异有统计学意义(P<0.01),但两组间同期比较差异无统计学意义(P>0.05)。结论伟素能够减少微量白蛋白尿期糖尿病肾病患者的尿白蛋白排泄率;与氯沙坦钾的疗效相当。Objective To assess the therapeutic effect of sulodexide for diabetic patients with early nephropathy. Methods A total of 60 patients with early diabetic nephropathy （albuminuria： 30 to 300 mg/24 h, male/female： 30/30, mean age： 51.23 years, mean course of disease： 12.9 years） were randomized equally into three groups： the routine treatment group, cozaar group （50 mg qd, po for 12 weeks） and sulodexid group （600 LSU qd, iv or im for 4 weeks, 250 LSU bid, po for 8 weeks）. The levels of urinary albumin excretion rate （UAER）, urea nitrogen and creatinine were determined. Results After three months of treatment, the level of UAER was decreased significantly in both the sulodexide group and cozaar group （P〈0.01）, but not in the routine treatment group （P〉0.05）. The level of UAER was reduced by 34.04% and 33.62% in the cozaar group and the sulodexide group, respectively. Significant difference was noted in the level of UAER between the cozaar/sulodexide groups and the routine treatment group （P〈0.01）, but no significant difference was observed between cozaar group and sulodexide group （P〉0.05）. Conclusion Sulodexide could decrease the level of UAER in patients with early diabetic nephropathy. It has similar efficacy to cozaar.

关 键 词：伟素 糖尿病肾病 微量白蛋白尿 尿白蛋白排泄率 随机对照试验 

分 类 号：R587.2[医药卫生—内分泌]