【摘要】 目的探讨普罗布考对糖尿病肾病患者的肾脏保护作用。方法 50例2型糖尿病肾病3期以上的患者随机分为普罗布考组(P组)和常规治疗组(C组),分别给予普罗布考加培哚普利和单用培哚普利治疗,检测治疗前、治疗后1个月和2个月的血糖、血脂、胰岛素、空腹C肽、餐后2 h C肽、胰岛素抵抗指数(HOMA-IR)、C反应蛋白(CRP)、纤维蛋白原(FIB)、Scr、24 h尿微量白蛋白、血糖达标时间及胰岛素用量等指标。结果两组治疗后FBG、PPG、HbA1c、HOMA-IR均有显著下降(P<0.05),空腹C肽、餐后2 h C肽显著升高,P组餐后2 h C肽升高、HOMA-IR下降,与C组相比差异有统计学意义(P<0.05)。P组胰岛素用量低于C组,两组间比较无差异。两组24 h尿微量白蛋白、血Scr均显著下降,P组尿微量白蛋白降低,与C组比较差异有统计学意义(P<0.05)。仅P组血脂(TG、TC、LDL-C)、CRP、FIB在治疗后显著下降(P<0.05)。结论 2型糖尿病肾病患者在使用ACEI的基础上联合使用普罗布考,可以更有效地减少尿微量白蛋白,改善胰岛素抵抗,保护胰岛β细胞功能,具有肾脏保护作用。更多还原

【Abstract】 【Objective】 To investigate the effect of Probucol on kidney function in type 2 diabetic nephropathy patients.【Methods】 A total of 50 Type 2 diabetic nephropathy patients were assigned randomly to receive perindopril combined with Probucol(P group,n =25) or perindopril only(C group,n =25) as their treatment regimens.The following variables were performed: plasma glucose,HbA1c,lipid,fasting insulin,fasting and postprandial C-peptide,the homeostatic model assessment of insulin resistance(HOMA-IR),CRP,FIB,24 hour urine microalbumin,the days for the glucose to reach normal,the dose of the insulin.The variables were analyzed before and after 1 and 2 months therapy.【Results】 There were significantly decreased in fasting plasma glucose(FBG),postprandial plasma glucose(PPG),HbA1c,HOMA-IR after the treatment,as well as fasting and postprandial C-peptide increased significantly.Compared with the C group,the postprandial C-peptide and the index of HOMA-IR were improved significantly in the P group.The doses of insulin of P group were less than the C group.The 24 hour urine microalbumin and the blood creatinine were significantly decreased in both groups.Only the TG,TC,LDL,CRP,FIB of the P group were significantly decreased versus the baseline.Most importance,the 24 hour urine microalbumin and the TC were decreased more in the P group vs C group.【Conclusion】 Probucol induced the more decreasing of the 24 hour urine microalbumin,relieving insulin resistance,as well as improving of pancreatic βcell function.更多还原