α-硫辛酸联合替米沙坦治疗早期2型糖尿病肾脏疾病的临床疗效观察  被引量:3

Clinical efficacy of alpha-lipoic acid combined with telmisartan in treating early type 2 diabetic kidney disease

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作  者:段纬喆[1] 赵湜[1] 

机构地区:[1]武汉市中心医院内分泌科,430012

出  处:《临床肾脏病杂志》2014年第7期415-419,共5页Journal Of Clinical Nephrology

基  金:2014年国家自然科学基金(NO.H0713)

摘  要:目的 观察应用α-硫辛酸联合替米沙坦治疗早期2型糖尿病肾脏疾病(diabetic kidney disease,DKD)的临床疗效及安全性.方法 选择2012年8月至2013年12月间116例诊断为早期2型糖尿病肾脏病的成人患者,采用随机数字表法将患者分为4组,每组29例.常规治疗组(对照组):予以控制饮食、降血糖和血压等常规治疗;替米沙坦组:在对照组基础上加用替米沙坦(80 mg/d,连用4周);α-硫辛酸组:在对照组基础上加用α-硫辛酸(600 mg/d,连用4周);联合用药组:在对照组的基础上加用替米沙坦和α-硫辛酸(二者用法同前).监测治疗后各组患者的血糖、尿微量白蛋白排泄率(urinary albumin excretion rate,UAER)及尿β2微球蛋白(β2-Microglobulin,β2-MG)水平,观察治疗期间患者的病情变化及不良反应.结果 治疗前,对照组、替米沙坦组、α-硫辛酸组及联合用药组的UAER分别为(118.5±13.3) μg/min、(122.8±12.1)μg/min、(121.2±11.3)μg/min和(119.2±11.7)μg/min,尿β2MG分别为(331.1±43.3) mg/L、(325.2±41.6) mg/L、(328.7±39.9) mg/L和(330.7±44.0)mg/L,4组间差异均无统计学意义(P>0.05).治疗后第4周,替米沙坦组、α硫辛酸组及联合用药组UAER和尿β2-MG较治疗前均呈下降趋势(P<0.01),UAER分别为(52.2±6.1) μg/min、(40.2±5.0) μg/min和(22.6±3.8) μg/min,尿β2-MG分别为(231.2±18.7)mg/L、(206.2±19.8)mg/L和(171.7±15.8) mg/L;与对照组[(78.1±7.3)μg/min和(268.1±22.3) mg/L]比较,其他3组UAER和尿β2-MG的下降幅度更大(P<0.01);其中联合用药组下降幅度最大(P<0.05),α硫辛酸组下降幅度大于替米沙坦组(P<0.05).治疗期间,4组患者的血糖和血压控制良好,肾功能未出现明显异常,均未发生严重的药物相关不良反应.结论 α-硫辛酸治疗早期2型糖尿病肾脏病是安全、有效的,能显著降低患者的UAER和尿β2-MG水平;Objective To observe the clinical efficacy and security of alpha-lipoic acid combined with telmisartan in treating early type 2 diabetic kidney disease (DKD).Methods 116 adults with type 2 DKD were enrolled in this study from August 2012 to December 2013.They were randomly divided into four groups (n =29 cases each group).The control group was given routine therapies such as con trolled eating,blood sugar lowering and other conventional treatments.On the basis of treatments in control group,the telmisartan group was given telmisartan (80 mg/day for 4 weeks),the alpha-lipoic acid group was given alpha-lipoic acid (600 mg/day for 4 weeks,and the combination group was given telmisartan (80 mg/day) for 4 weeks plus alpha lipoic acid (600 mg/day) for 4 weeks.The blood glu cose,urinary albumin excretion rate (UAER) and urine β2-microglobulin (β2-MG) levels were meas ured.Changes in disease conditions and adverse reactions in these patients were observed.Results Before the treatment,UAER in control group,telmisartan group,alpha-lipoic acid group and combination group was (118.5 ± 13.3),(122.8 ± 12.1),(121.2 ± 11.3) and (119.2 ± 11.7) μg/min respec tively,and urinary β2-MG levels were (331.1 ± 43.3),(325.2 ± 41.6),(328.7 ± 39.9) and (330.7 ± 44) mg/L respectively.They had no significant difference among the four groups (P>0.05).After treatment for 4 weeks,the UAER [(52.2 ± 6.1) μg/min,(40.2 ± 5) μg/min and (22.6 ± 3.8) μg/ min respectively] and urinary β2-MG levels [(231.2 ± 18.7) mg/L,(206.2 ± 19.8) mg/L and (171.7 ± 15.8) mg/L respectively] in telmisartan group,alpha-lipoic acid group and combination group were significantly decreased (P<0.01) as compared with those before treatment.The UAER and urinary β2-MG levels in telmisartan group,alpha-lipoic acid group and combination group were decreased more rapidly as compared with those in control group [(78.1 ± 7.3) μg/min and (268.1 ± 22.3) m

关 键 词:2型糖尿病 糖尿病肾脏病 Α-硫辛酸 

分 类 号:R587.1[医药卫生—内分泌]

 

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