糖尿病性肾脏疾病不同分期的临床治疗效果观察  

Study on therapeutic effect of treatment in different stages of diabetic kidney disease(DKD)

作　　者：陈金逸 符茂雄 

机构地区：[1]海南省农垦总医院内分泌科,海南海口570311

出　　处：《临床和实验医学杂志》2014年第12期1019-1021,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的研究糖尿病性肾脏疾病(DKD)患者在不同分期的临床治疗效果。方法选取2010年8月至2013年8月来我院治疗的40例蛋白尿<0.5 g/24 h的DKD患者为早期组,选取40例蛋白尿≥0.5 g/24 h的患者为中期组。两组患者给予联合应用缬沙坦和贝那普利,进行3个月治疗,研究糖尿病的调脂、降血压,测量患者的血压、血糖、糖化血红蛋白(HbA1c)、内生肌酐清除率(Ccr)、血清肌酐(Scr)、尿素氮(BUN)、尿总蛋白排泄率(UPER)等指标。对80例患者进行12个月的随访。结果治疗后两组患者的血压、血糖和HbA1c的值均有所下降,且在治疗前后差异有统计学意义(P<0.05)。早期组在治疗前后的UPER值的变化程度显著,差异有统计学有意义(P<0.05);中期组患者在治疗前后的UPER值的变化程度不显著,差异无统计学意义(P>0.05)。两组患者在治疗前后BUN、Ccr和Scr的净变化值间差异显著,有统计学意义(P<0.01)。早期组和中期组患者的1年肾脏存活率分别为97.50%和72.50%,差异有统计学意义(P<0.05)。结论对DKD患者进行临床干预,早期的DKD患者从中获益最大。Objective To study the clinical effect of treatment in patients with diabetic kidney disease （DKD） at different stages. Methods A total of 40 eases of DKD with urinary protein 〈 0. 5 g/24 h in this hospital during August 2010 to August 2013 were selected as early group, then 40 cases of DKD with urinary protein ≥ 0.5 g/24 h were allocated as middle group, and they were treated with valsartan and benaze- pril for 3 months for lowering blood pressure and lipids, then their blood pressure, blood glucose, HbA1 c, serum creatinine, urea nitrogen, the urinary protein excretion rate and other indicators were examined and compared, and 80 patients of them were followed up for 12 months. Results After treatment, the BP, and blood levels of glucose and HbA1 c were decreased in these 2 groups, and the difference in these indicators between pre - treatment and post - treatment was statistically significant （ P 〈 0.05 ）. The difference in UPER of early group before and after treatment was statistically significant （ p 〈 0. 05 ） ; the degree of changes in UPER of patients in second group before and after treatment was not statistically significant （ P 〉0.05 ）. The difference in changes of BUN, Ccr and Scr in these two groups before and after treatment was statistically significant （ P 〈 0.05 ）. The 1 year renal survival rates in these 2 groups were 97.50% and 72.50% respectively, and their difference was statistically significant （ P 〈 0.05 ）. Conclusion Clinical intervention on patients with DKD, the benefit for patients with early DKD is the greatest.

关 键 词：糖尿病性肾脏疾病 蛋白尿 临床疗效 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]