李海娟

[摘要] 目的 观察氯沙坦联合雷公藤多苷片治疗糖尿病肾病的临床疗效及尿微量白蛋白等指标的影响。方法 选取2016年6月—2018年6月该院收治的糖尿病肾病患者62例，常规组应用氯沙坦进行治疗，试验组应用氯沙坦联合雷公藤多苷片進行治疗，每组31例。对比2组患者治疗后临床效果及尿微量白蛋白指标的差异性。结果 治疗后，试验组治疗有效率为83.87%，明显高于常规组的51.61%，差异有统计学意义（χ2=7.38，P<0.05）;治疗后，试验组患者24 h尿白蛋白、血肌酐、尿素氮指标水平分别为（52.05±7.11）mg/24 h、（55.17±6.24）μmol/L、（5.05±1.11）mmol/L，相比治疗前明显改善（P<0.05），且改善情况明显优于常规组，差异有统计学意义（t=74.05，9.76，3.99，P<0.05）。结论 氯沙坦联合雷公藤多苷片治疗糖尿病肾病的临床疗效及尿微量白蛋白等指标的影响显著，可推广应用。

[关键词] 氯沙坦;雷公藤多苷片;糖尿病肾病;临床疗效

[中图分类号] R587.2;R692.9          [文献标识码] A          [文章编号] 1672-4062（2018）12（b）-0196-03

[Abstract] Objective To observe the clinical efficacy of losartan combined with tripterygium glycosides in the treatment of diabetic nephropathy and the influence of urine microalbumin. Methods 62 patients with diabetic nephropathy admitted to our hospital from June 2016 to June 2018 were enrolled. The routine group was treated with losartan. The test group was treated with losartan combined with tripterygium glycosides. 31 cases in each group. The clinical effects and urinary microalbumin index differences between the two groups were compared. Results After treatment， the effective rate of the experimental group was 83.87%， which was significantly higher than 51.61% of the conventional group，the different was statistically significant（χ2=7.38， P<0.05）. After treatment， the level of urinary albumin of 24 h， serum creatinine and urea nitrogen in the experimental group were （52.05±7.11）mg/24 h， （55.17±6.24）μmol/L， （5.05±1.11）mmol/L， which was significantly improved compared with before treatment （P<0.05）， and the improvement was significantly better than the conventional group，the different was statistically significant（t=74.05，9.76， 3.99， P<0.05）. Conclusion The clinical effects of losartan combined with tripterygium glycosides in the treatment of diabetic nephropathy and the effects of urinary microalbumin are significant and can be applied.

[Key words] Losartan; Tripterygium glycosides tablets; Diabetic nephropathy; Clinical efficacy

糖尿病肾病是临床常见的疾病之一，多利用氯沙坦等药物治疗，但大量临床数据揭示，单一药物治疗药效缓慢，临床效果欠佳[1-3]。该院选择2016年6月—2018年6月期间收治的62例糖尿病肾病患者为研究对象，观察氯沙坦联合雷公藤多苷片治疗糖尿病肾病的临床疗效及尿微量白蛋白等指标的影响，为临床提供参考依据，现报道如下。

1  资料与方法

1.1  一般资料

选取该院收治的糖尿病肾病患者62例，纳入标准：①符合糖尿病肾病的临床判定标准;②伴随明显蛋白尿、水肿、高血压、贫血、肾功能异常等临床症状者;③经实验室检查、尿糖定性试验检查、血糖测定检查、尿白蛋白测定检查、尿酶测定检查、血生化测定检查、肾脏影像学检查、糖尿病性眼底检查等相关实验室检查确诊者;④患者知情同意该次研究。排除标准：①不符合纳入标准者;②凝血功能异常者;③合并严重器质性病变疾病者;④对氯沙坦、雷公藤多苷片药物过敏者;⑤有家族性遗传疾病及个人史者;⑥存在明显沟通障碍者。……