【摘要】 目的探讨替米沙坦联合阿托伐他汀治疗早期糖尿病肾病(DKD)的效果。方法选取2016年7月至2017年9月于河南省人民医院门诊就诊和住院的60例早期DKD患者,按随机数表法分为替米沙坦组、阿托伐他汀组和联合组,每组20例。在常规治疗的基础上,替米沙坦组患者口服替米沙坦片,阿托伐他汀组患者口服阿托伐他汀片,联合组患者口服替米沙坦片和阿托伐他汀片,疗程3个月。联合组研究期间失访脱落1例。比较3组患者治疗前后总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、血清胱抑素C(CysC)、24 h尿微量白蛋白排泄率(UAER)和尿nephrin水平。结果联合组治疗后TG、CysC、24 h UAER和尿nephrin水平均低于治疗前,差异有统计学意义(均P<0.05)。治疗后,联合组TC、TG、LDL-C、CysC和尿nephrin水平均低于替米沙坦组,联合组TG、24 h UAER和尿nephrin水平均低于阿托伐他汀组,差异有统计学意义(均P<0.05)。结论替米沙坦联合阿托伐他汀治疗早期DKD的效果确切,有助于控制血脂和血清CysC,减少尿nephrin的排泄,从而降低尿微量白蛋白水平。更多还原

【Abstract】 Objective To investigate the effect of combined therapy with telmisartan and atorvastatin on diabetic kidney disease(DKD) in early stage.Methods A total of 60 outpatients and inpatients with early DKD in Henan Provincial People’s Hospital from July 2016 to September 2017 were selected. They were divided into telmisartan group, atorvastatin group, and combined group according to random number table method, with 20 cases in each group. On the basis of routine treatment, the patients in telmisartan group took orally telmisartan tablets, and the patients in atorvastatin group took orally atorvastatin tablets, and the patients in combined group took orally telmisartan tablets and atorvastatin tablets. The course of treatment was 3 months. One case was lost during the study in combined group. The levels of total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDL-C), serum cystatin C(CysC), 24 h urinary microalbumin excretion rate(UAER) and urinary nephrin were compared before and after treatment in the three groups.Results After treatment, the levels of TG, CysC, 24 h UAER and urinary nephrin in combined group were lower than those before treatment, and the differences were statistically significant(all P<0.05). After treatment, the levels of TC, TG, LDL-C, CysC and urinary nephrin in combined group were lower than those in telmisartan group, and the levels of TG, 24 h UAER and urinary nephrin in combined group were lower than those in atorvastatin group, while the differences were statistically significant(all P<0.05).Conclusion Telmisartan combined with atorvastatin has definite effect in the treatment of early DKD, which is helpful to control blood lipid and serum CysC, reduce urinary nephrin excretion, and thus reduce urinary microalbumin.更多还原