非奈利酮联合缬沙坦治疗1~3a期慢性肾病伴糖尿病肾病的疗效和安全性分析  

Efficacy and safety analysis of fenelidone combined with valsartan in the treatment of 1~3a stage chronic kidney disease with diabetes nephropathy

作　　者：何升林 李辉[1] 杨雀 He Shenglin;Li Hui;Yang Que(Endocrinology and Diabetes Hospital of Shaanxi Provincial People’s Hospital,Xi’an 710068,China)

机构地区：[1]陕西省人民医院内分泌糖尿病病院,西安710068 [2]西安医学院第二附属医院肾脏内分泌科,西安710038

出　　处：《中华内分泌外科杂志（中英文）》2024年第6期784-788,共5页Chinese Journal of Endocrine Surgery

基　　金：陕西省自然科学基础基金(2022JM-516)。

摘　　要：目的探究非奈利酮联合缬沙坦治疗1~3a期慢性肾病(CKD)伴糖尿病肾病(DKD)疗效和安全性。方法随机数字表法将100例1~3a期CKD伴DKD患者分为两组。对照组在常规治疗基础上服用缬沙坦,观察组联合服用缬沙坦和非奈利酮。比较两组血糖[空腹血糖(FBG)、糖化血红蛋白(HbAlc)、餐后2 h血糖(P2hBG)]、收缩压(SBP)、肾功能指标[尿β2微球蛋白(β2-MG)、24 h尿蛋白定量(24 hUPr)、血肌酐(Scr)、血尿素氮(BUN)]、炎症指标[C反应蛋白(CRP)、高迁移率族蛋白B1(HMGB1)和转化生长因子β1(TGF-β1)]、氧化应激指标[丙二醛(MDA)、活性氧(ROS)和抗氧化剂超氧物歧化酶(SOD)、总抗氧化能力(T-AOC)]和不良反应。结果观察组治疗后FBG、HbAlc、P2hBG、SBP、β2-MG、24 hUPr、Scr、BUN、CRP、HMGB1、TGF-β1、MDA、ROS均明显低于对照组(P<0.05);观察组治疗后的SOD和T-AOC分别为(120.74±16.85)U/mL、(31.38±4.16)U/mL,均明显高于对照组的(101.62±15.82)U/mL和(20.96±3.91)U/mL,差异具有统计学意义(P<0.05)。观察组治疗后的血钾水平为(4.16±0.62)mmol/L,不良反应发生率为8.00%,对照组血钾水平为(4.21±0.71)mmol/L,不良反应发生率为10.00%,两组间差异无统计学意义(P>0.05)。结论非奈利酮与缬沙坦联合有助于改善1~3a期CKD伴DKD患者血糖、血压,保护患者肾功能,且安全性良好,这可能与降低氧化炎症反应,增强机体抗氧化能力等有关。ObjectiveTo explore the efficacy and safety of finelidone combined with valsartan in the treatment of 1-3a stage chronic kidney disease(CKD)with diabetic nephropathy(DKD).MethodsA total of 100 cases with 1~3a stage CKD with DKD were divided into two groups by random number table method.The control group was treated by valsartan on the basis of conventional treatment,and the observation group was treated by valsartan combined with finelidone.Blood glucose[fasting blood glucose(FBG),glycated hemoglobin(HbAlc),2h postmeal blood glucose(P2hBG)],systolic blood pressure(SBP),renal function indicators[β2 microglobulin(β2-mg),24h urinary protein quantity(24hUPr),blood creatinine(Scr),blood urea nitrogen(BUN)and blood potassium],inflammation indicators[C-reactive protein(CRP),high mobility group protein B1(HMGB1)and transforming growth factorβ1(TGF-β1)],oxidative stress markers[malondialdehyde(MDA),reactive oxygen species(ROS)and antioxidant superoxide dismutase(SOD),total antioxidant capacity(T-AOC)]and adverse reactions was compared between two groups.ResultsAfter treatment,the levers of FBG,HbAlc,P2hBG,SBP,β2-MG,24hUPr,Scr,BUN,CRP,HMGB1,TGF-β1,MDA and ROS in the observation group were significantly lower than those in the control group(P<0.05).The level of SOD and T-AOC in the observation group after treatment were(120.74±16.85)U/mL and(31.38±4.16)U/mL,respectively,significantly higher than(101.62±15.82)U/mL and(20.96±3.91)U/mL in the control group,and the differences were significant(P<0.05).After treatment,the serum potassium level in the observation group was(4.16±0.62)mmol/L,and the incidence of adverse reactions was 8.00%,while that in the control group was(4.21±0.71)mmol/L,and the incidence of adverse reactions was 10.00%,with no significant difference between the two groups(P>0.05).ConclusionFinelidone combined with valsartan can improve blood glucose and blood pressure of 1~3a stage CKD with DKD and protect renal function with good safety,which may be related to reducing oxidative inflammation and e

关 键 词：慢性肾病 1~3a期 糖尿病肾病 缬沙坦 非奈利酮 

分 类 号：R692.9[医药卫生—泌尿科学] R587.2[医药卫生—外科学]