胰激肽原酶辅助治疗糖尿病肾病的临床疗效及对患者肾功能与血糖水平和炎症因子的影响  

Clinical efficacy of pancreatic kininogenase in adjuvant treatment of diabetic nephropathy and its influence on renal functionandblood sugar level and inflammatory factors

作　　者：马晶[1] 梁桂敏[1] MA Jing;LIANG Guimin(Department of Endocrinology,Harbin First Hospital,Harbin,Heilongjiang,150000,China)

机构地区：[1]哈尔滨市第一医院内分泌一科,黑龙江哈尔滨150000

出　　处：《当代医学》2024年第1期82-85,共4页Contemporary Medicine

摘　　要：目的探讨胰激肽原酶辅助治疗糖尿病肾病(DN)患者的临床疗效。方法选取2020年2月至2021年10月哈尔滨市第一医院收治的113例DN患者作为研究对象,按照随机数字表法分为B组(n=56)与A组(n=57)。B组给予贝那普利治疗,A组在B组基础上联合胰激肽原酶辅助治疗,比较两组临床疗效、肾功能、血糖水平、炎症因子和25-羟维生素D_(3)[25-(OH)D_(3)]水平及不良反应发生率。结果A组治疗总有效率高于B组(93.18%vs.76.75%),差异有统计学意义(P<0.05)。治疗12周后,两组24h尿蛋白水平、尿微量白蛋白/尿肌酐比值(UACR)、24h微量白蛋白排泄率(UAER)均低于治疗前,且A组低于B组,差异有统计学意义(P<0.05)。治疗12周后,两组糖化血红蛋白A1c(HbA1c)、空腹血糖(FBG)和餐后2h血糖(2hPBG)水平均低于治疗前,且A组低于B组,差异有统计学意义(P<0.05)。治疗12周后,两组肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)水平均低于治疗前,25-(OH)D_(3)、白细胞介素2(IL-2)水平均高于治疗前,且A组TNF-α、IL-6水平均低于B组,25-(OH)D_(3)、IL-2水平均高于B组,差异有统计学意义(P<0.05)。A组与B组不良反应发生率(12.25%vs.8.95%)比较差异无统计学意义。结论胰激肽原酶辅助治疗DN效果显著,可明显降低炎症因子水平,改善患者肾功能和25-(OH)D_(3)水平,控制血糖稳定,且不增加不良反应的发生。Objective To explore the clinical efficacy of pancreatic kininogenase in the adjuvant treatment of diabetic nephropathy(DN).Methods 113 patients with DN admitted to the Harbin First Hospital from February 2020 to October 2021 were selected as the research subject,and they were divided into the group B(n=56)and the group A(n=57)according to the random number table method.The group B was treated with bena-zepril,while the group A was treated with pancreatic kininogenase on the basis of the group B,the clinical efficacy,renal function,blood sugar level,inflammatory factors and 25-hydroxyvitamin D_(3)(25-[OH]D_(3))levels and the incidence of adverse reactions were compared between the two groups.Results The total effective rate in the group A was higher than that in the group B(93.18%vs.76.75%),and the difference was statistically signifi-cant(P<0.05).After 12 weeks of treatment,the 24 h urinary protein level,urinary microalbumin/creatinine ratio(UACR)and 24 h microalbumin ex-cretion rate(UAER)of the two groups were lower than before treatment,and the group A was lower than the group B,and the differences were statis-tically significant(P<0.05).After 12 weeks of treatment,the levels of glycosylated hemoglobin A1c(HbA1c),fasting blood glucose(FBG)and 2 h postprandial blood glucose(2 h PBG)of the two groups were lower than those before treatment,and the group A was lower than the group B,and the differences were statistically significant(P<0.05).After 12 weeks of treatment,the levels of tumor necrosis factor-α(TNF-α)and interleukin 6(IL-6)of the two groups were lower than those before treatment,and the levels of 25-(OH)D_(3) and interleukin 2(IL-2)were higher than those before treat-ment,the levels of TNF-αand IL-6 in the group A were lower than those in the group B,and the levels of 25-(OH)D_(3) and IL-2 were higher than those in the group B,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the group A and the group B(12.25%v

关 键 词：糖尿病肾病 胰激肽原酶 贝那普利 肾功能 炎症因子 血糖 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]