张小东

【摘要】 目的 深入研究糖尿病腎病患者的治疗药物及效果。方法 80例糖尿病肾病患者， 随机分成研究组与参照组， 每组40例。研究组患者采用罗格列酮与厄贝沙坦治疗， 参照组患者采用二甲双胍与氨氯地平治疗。记录并比较两组患者治疗前后微量尿蛋白、尿蛋白、血糖、血压等变化情况。结果 治疗前， 研究组微量尿蛋白为（229.7±208.4）mg/L、尿蛋白为（1.1±0.9）g/24 h；参照组分别为（226.3±231.7）mg/L、（1.2±1.0）g/24 h。治疗后， 研究组微量尿蛋白为（126.9±108.3）mg/L、尿蛋白为（0.5±

0.4）g/24 h；参照组分别为（158.4±129.6）mg/L、（0.7±0.6）g/24 h。治疗前两组微量尿蛋白、尿蛋白水平比较差异无统计学意义（P>0.05）；治疗后两组患者微量尿蛋白、尿蛋白均下降， 且研究组下降幅度大于参照组， 差异具有统计学意义（P<0.05）。治疗前， 两组患者血压、血糖水平比较差异无统计学意义（P>0.05）；治疗后， 两组患者血压、血糖均有所下降， 且研究组下降幅度大于参照组， 差异具有统计学意义（P<0.05）。结论 罗格列酮与厄贝沙坦能将尿蛋白、血糖、血压等指标控制在正常范围内， 有效缓解临床表现， 提高预后效果， 应推广使用。

【关键词】 糖尿病肾病；尿蛋白；药物治疗；效果

DOI：10.14163/j.cnki.11-5547/r.2017.05.048

Research of drug therapy for urine protein in diabetic nephropathy patients ZHANG Xiao-dong. Department of Nephrology， First Auto Work General Hospital， Changchun 130011， China

【Abstract】 Objective To thoroughly research drug and effect in treatment of diabetic nephropathy patients. Methods A total of 80 patients with diabetic nephropathy were randomly divided into research group and control group， with 40 cases in each group. The research group received rosiglitazone and irbesartan for treatment， and the control group received metformin and amlodipine for treatment. Records and comparison were made on changes in urine microprotein， urine protein， blood glucose and blood pressure before and after treatment between the two groups. Results Before treatment， the research group had urine microprotein as （229.7±208.4） mg/L

and urine protein as （1.1±0.9） g/24 h， which were respectively （226.3±231.7） mg/L and （1.2±1.0） g/24 h in the control group. After treatment， the research group had urine microprotein as （126.9±108.3） mg/L and urine protein as （0.5±0.4） g/24 h， which were respectively （158.4±129.6） mg/L and （0.7±0.6） g/24 h in the control group. There was no statistically significant difference of urine microprotein and urine protein before treatment between the two groups （P>0.05）. After treatment， both groups had lowered urine microprotein and urine protein， and the research group had larger descend range tan the control group. The difference had statistical significance （P<0.05）. Before treatment， there was no statistically significant difference of blood pressure and blood glucose levels between the two groups （P>0.05）. After treatment， both groups had lowered blood pressure and blood glucose， and the research group had larger descend range tan the control group. The difference had statistical significance （P<0.05）. Conclusion Rosiglitazone and irbesartan can control urine protein， blood glucose and blood pressure in normal range. It shows effect in relieving clinical manifestation and improving prognosis. This method ought to be promoted and applied.

【Key words】 Diabetic nephropathy； Urine protein； Drug therapy； Effect

糖尿病患者倘若治疗不及时[1， 2]， 很容易发展成糖尿病肾病综合征， 十分不利于后期康复。糖尿病肾病患者的临床表现主要为尿蛋白， 初期排量一般为30～300 mg/24 h， 此时通过药物干预会获得较好疗效， 但该时段发病缺少特异性， 容易错失治疗时机[3-5]。当尿蛋白排量达到每天500 mg时， 则可确诊为糖尿病肾病[6]。本院选择2015年3月～2016年3月在本院接受治疗的80例糖尿病肾病患者作为研究对象， 分析其疗效。……