缬沙坦联合α-硫辛酸治疗早期糖尿病肾病患者的效果及对血清ET、β2-MG水平的影响  

Effect of valsartan combined with α-lipoic acid on early diabetic nephropathy and its effect on serum ET and β_2-MG levels

作　　者：李阳[1] 高明松[1] 孔彩霞[1] 肖方喜[1] 李伟[1] 叶正华[1] LI Yang;GAO Mingsong;KONG Caixia;XIAO Fangxi;LI Wei;YE Zhenghua(Department of Endocrinology,Wuhan First Hospital,Hubei Province,Wuhan 430022,China)

机构地区：[1]武汉市第一医院内分泌科,430022

出　　处：《疑难病杂志》2018年第11期1217-1220,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察缬沙坦联合α-硫辛酸治疗早期糖尿病肾病的临床效果及其对血清内皮素(ET)、β_2微球蛋白(β2-MG)的影响。方法选择2016年6月—2017年9月武汉市第一医院内分泌科收治的早期糖尿病肾病患者86例作为研究对象,随机数字表法均分为观察组和对照组,每组43例。对照组患者采用缬沙坦治疗,观察组采用缬沙坦联合α-硫辛酸治疗。治疗4个月后,比较2组治疗效果及治疗前后血、尿各项指标的变化。结果观察组治疗总有效率高于对照组(88. 4%vs. 69. 8%,χ~2=4. 503,P=0. 034);治疗后对照组及观察组患者尿液m Alb、NAG、UAER均较治疗前降低(t/P_(对照组)=11. 382、10. 512、7. 292,P均=0. 000; t/P_(观察组)=19. 153、15. 221、10. 902,P均=0. 000),且观察组均低于对照组(t/P=8. 691、6. 873、2. 623,P均=0. 000);治疗前后2组患者组内、组间FPG、HbA_(lc)比较差异均无统计学意义(P> 0. 05);对照组及观察组患者血清ET、β_2-MG均降低(t/P_(对照组)=6. 760、8. 107,P均=0. 000; t/P_(观察组)=15. 788、15. 565,P均=0. 000),且观察组均低于对照组(t/P=8. 968、8. 804,P均=0. 000)。2组不良反应发生率比较,差异无统计学意义(χ~2=0. 574,P=0. 451)。结论采用缬沙坦联合α-硫辛酸治疗早期糖尿病肾病安全有效,能够明显降低血清ET、β_2-MG水平,改善患者临床症状。Objective To investigate the clinical effect of valsartan combined with alpha-lipoic acid on early diabetic nephropathy and its effect on serum ET andβ2-MG.Methods Eighty-six patients with early diabetic nephropathy treated in department of endocrinology,Wuhan First Hospital from June 2016 to September 2017 were selected as the study subjects.The patients were divided into observation group and control group,43 cases in each group.Patients in the control group were treated with valsartan,and observation groups were treated with valsartan andα-lipoic acid,changes were compared between the two groups.Results The total effective rate of treatment in the observation group was higher than that in the control group(88.4%vs 69.8%,χ2=4.503,P=0.034).The urinary mAlb,NAG,and UAER in the control group and the observation group were lower than those before treatment(control group:t=11.382,t=10.512,t=7.292,all P=0.000;observation group:t=19.153,t=15.221,t=10.902,all P=0.000),and the observation group was lower than the control group(group comparison:t=8.691,t=6.873,t=2.623,all P=0.000);before and after treatment,the difference of FPG and HbA lc between the two groups were not statistical significance(P>0.05).Serum ET andβ2-MG were decreased in the control group and the observation group(control group:t=6.760,t=8.107,all P=0.000;observation group:t=15.788,t=15.565,all P=0.000),and the observation group was lower than the control group(group comparison:t=8.968,t=8.804,all P=0.000).There was no significant difference in the incidence of adverse reactions between the two groups(χ2=0.574,P=0.451).Conclusion Valsartan combined withα-lipoic acid is safe and effective in the treatment of early diabetic nephropathy,which can significantly reduce serum ET andβ2-MG levels and improve clinical symptoms.

关 键 词：糖尿病肾病 缬沙坦 Α-硫辛酸 内皮素 Β2-微球蛋白 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]