【摘要】 目的:探讨他克莫司联合厄贝沙坦治疗糖尿病肾病的疗效及对血清血管生成素样蛋白4(Angptl4)、生长分化因子-15(GDF-15)、结缔组织生长因子(CTGF)的影响。方法:选择2016年8月至2018年8月我院接诊的糖尿病肾病患者105例,随机数表法分为观察组55例和对照组50例。两组均进行,对照组给予常规治疗,并给予厄贝沙坦口服;观察组在对照组基础上联合他克莫司注射液治疗,连续治疗21d。比较两组血清Angptl4、GDF-15、CTGF(酶联免疫吸附法)、血糖、肾功能的变化及不良反应。结果:治疗后,观察组血清Angptl4、GDF-15、CTGF明显比对照组低(P<0.05);两组治疗前后空腹血糖(FBG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)比较差异均无统计学意义(P>0.05);观察组尿素氮(BUN)、血肌酐(SCr)、24h尿微量蛋白排泄率(UAER)明显比对照组低(P<0.05);两组不良反应总发生率差异无统计学意义(P>0.05)。结论:他克莫司联合厄贝沙坦治疗糖尿病肾病效果显著,可有效降低血清Angptl4、GDF-15、CTGF表达,改善肾血管功能,促进肾功能恢复,且不增加药物不良反应,临床应用价值高。更多还原

【Abstract】 Objective: To study the curative efficacy of tacrolimus combined with irbesartan in treatment of diabetic nephropathy and effects on serum angiopoietin-like protein 4(Angptl4), growth differentiation factor-15(GDF-15) and connective tissue growth factor(CTGF) levels. Methods: 105 patients of diabetic nephropathy who received therapy from August 2016 to August 2018 in our hospital were selected as research objects, according to the random number table,those patients were divided into the 55 cases of the observation group and the 50 cases of the control group, they were received routine treatment, the control group was treated with irbesartan on the basis of the above, while the observation group was treated with tacrolimus injection on the basis of the control group, they were treated for 21 days. The changes of serum Angptl4, GDF-15, CTGF(Enzyme-linked immunosorbent assay), blood sugar, renal function and adverse reactions were observed in both groups. Results: After treatment, the serum Angptl4, GDF-15 and CTGF levels in the observation group were significantly lower than those in the control group(P<0.05); there was no significant difference in fasting blood glucose(FBG), postprandial blood glucose(2 hPG) and glycosylated hemoglobin(HbA1 c) between the two groups before and after treatment(P>0.05); the urea nitrogen(BUN), serum creatinine(SCr) and 24-hour urinary microprotein excretion rate(UAER) in the observation group were significantly lower than those in the control group(P<0.05); there was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05). Conclusion: Tacrolimus combined with irbesartan is well for diabetic nephropathy, which can effectively reduce the expression of serum Angptl4, GDF-15 and CTGF, improve renal vascular function and promote the recovery of renal function, and without increasing adverse drug reactions, it has high clinical value.更多还原