螺内酯联合缬沙坦在早期糖尿病肾病治疗中的价值分析  

Value analysis of spironolactone combined with valsartan in the treatment of early diabetic nephropathy

作　　者：李凯翔 张浩 曹丽[1] 郑亚莉[1] 鄂静[1] LI Kai-xiang;ZHANG Hao;CAO Li(Department of Nephrology,People's Hospital of Ningxia Hui Autonomous Region,Yinchuan 750000,China)

机构地区：[1]宁夏回族自治区人民医院肾脏内科,750000

出　　处：《中国现代药物应用》2023年第23期29-33,共5页Chinese Journal of Modern Drug Application

基　　金：足细胞特异性过表达RTN1A通过上皮间充质转化促进糖尿病肾病进展的研究(项目编号:2023AAC05054)。

摘　　要：目的探讨螺内酯联合缬沙坦在早期糖尿病肾病治疗中的价值。方法120例早期糖尿病肾病患者,按随机数字表法分为对照组和研究组,每组60例。对照组选择缬沙坦治疗,研究组选择螺内酯联合缬沙坦治疗。对比两组患者治疗效果、血糖指标[糖化血红蛋白(HbA1c)、餐后2 h血糖(2 h PBG)及空腹血糖(FBG)]、肾功能指标[血清肌酐(SCr)、24 h尿蛋白定量、血清尿素氮(BUN)]、炎性因子[白细胞介素-6(IL-6)、降钙素原(PCT)、C反应蛋白(CRP)]、血脂指标[总胆固醇(TC)、甘油三酯(TG)以及低密度脂蛋白胆固醇(LDL-C)]、血液流变学指标、生活质量。结果研究组患者治疗总有效率为95.0%,高于对照组的83.3%,差异具有统计学意义(P<0.05)。治疗后,研究组患者HbA1c、2 h PBG、FBG水平分别为(7.3±0.5)%、(7.9±0.5)mmol/L、(6.9±0.3)mmol/L,均低于对照组的(8.6±0.7)%、(9.3±0.8)mmol/L、(7.7±0.5)mmol/L,差异具有统计学意义(P<0.05)。治疗后,研究组患者SCr、24 h尿蛋白定量、BUN水平分别为(228.1±23.2)μmol/L、(1.01±0.12)g/24 h、(11.76±2.64)mmol/L,均低于对照组的(308.3±24.1)μmol/L、(1.33±0.15)g/24 h、(15.17±2.36)mmol/L,差异具有统计学意义(P<0.05)。治疗后,研究组患者IL-6、PCT、CRP、TC、TG、LDL-C水平分别为(28.5±6.6)pg/ml、(0.2±0.1)ng/L、(9.3±2.4)mg/L、(5.13±1.20)mmol/L、(1.25±0.70)mmol/L、(2.59±0.60)mmol/L,均低于对照组的(34.5±8.2)pg/ml、(0.8±0.1)ng/L、(13.6±3.2)mg/L、(5.79±1.30)mmol/L、(1.82±0.80)mmol/L、(3.25±0.60)mmol/L,差异具有统计学意义(P<0.05)。治疗后,两组患者全血高切粘度、全血低切粘度、血浆粘度、血细胞比容、纤维蛋白原水平均低于本组治疗前,且研究组患者低于对照组,差异具有统计学意义(P<0.05)。治疗后,两组患者情感职能、躯体疼痛、精神健康、生理职能、社会功能、生理功能、活力、总体健康评分均高于本组治疗前,且研究组患者高于对照组,差异Objective To discuss the value of spironolactone combined with valsartan in the treatment of early diabetic nephropathy.Methods A total of 120 patients with early diabetic nephropathy were divided into a control group and a study group according to random numerical table,with 60 cases in each group.The control group was treated with valsartan,and the study group was treated with spironolactone and valsartan.Both groups were compared in terms of therapeutic effect,blood glucose indexes[glycosylated hemoglobin(HbA1c),2 h postprandial blood glucose(2 h PBG)and fasting blood glucose(FBG)],renal function indexes[serum creatinine(SCr),24-h urinary protein excretion,blood urea nitrogen(BUN)],inflammatory factors[interleukin-6(IL-6),procalcitonin(PCT),C-reactive protein(CRP)],lipid indexes[total cholesterol(TC),triglycerides(TG),and low-density lipoprotein cholesterol(LDL-C)],hemorheological indexes,and quality of life.Results The total effective rate in the study group was 95.0%,which was higher than that of 83.3%in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of HbA1c,2 h PBG and FBG in the study group were(7.3±0.5)%,(7.9±0.5)mmol/L and(6.9±0.3)mmol/L,which were lower than those of(8.6±0.7)%,(9.3±0.8)mmol/L and(7.7±0.5)mmol/L in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of SCr,24-h urinary protein excretion and BUN were(228.1±23.2)μmol/L,(1.01±0.12)g/24 h and(11.76±2.64)mmol/L,which were lower than those of(308.3±24.1)μmol/L,(1.33±0.15)g/24 h and(15.17±2.36)mmol/L in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of IL-6,PCT,CRP,TC,TG and LDL-C in the study group were(28.5±6.6)pg/ml,(0.2±0.1)ng/L,(9.3±2.4)mg/L,(5.13±1.20)mmol/L,(1.25±0.70)mmol/L and(2.59±0.60)mmol/L,which were lower than those of(34.5±8.2)pg/ml,(0.8±0.1)ng/L,(13.6±3.2)mg/L,(5.79±1.30)mmol/L,(1.82±0.80)mmol/L and(3.25±0.60)mmol/L in the control group.The

关 键 词：螺内酯 缬沙坦 早期糖尿病肾病 治疗效果 安全性 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]