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目的探讨阿托伐他汀联合阿魏酸钠治疗糖尿病肾病的临床疗效及其对肾间质纤维化的影响,为糖尿病肾病的治疗提供临床依据。方法选取2014年1月至2016年1月在青海省第五人民医院行治疗的糖尿病肾病患者92例作为研究对象,随机分为对照组和联合治疗组,每组46例。比较两组患者治疗前后血糖和肾功能指标的变化以及两组患者治疗后的临床疗效。用SPSS 17.0软件进行t检验和χ~2检验。结果两组患者治疗后,除了对照组中血管紧张素Ⅱ(AngⅡ)和结缔组织生长因子(CTGF)含量无明显改变之外,两组患者血清中肿瘤生长因子-β(TGF-β)、Ⅳ型胶原(CⅣ)和Ⅲ型前胶原(PCⅢ)含量均较对照组明显下降,联合治疗组下降幅度明显大于对照组,差异均有统计学意义(P<0.05);两组患者空腹血糖(FPG)、餐后2 h血糖(2 h PG)水平均较治疗前明显降低,肾功能相关指标血尿素氮(BUN)、血肌酐(SCr)、24 h尿白蛋白排除率(UAER)、β_2-微球蛋白(β_2-MG)以及肾小球滤过率(GFR)均较治疗前明显降低,且联合治疗组降低幅度明显大于对照组,差异均有统计学意义(P<0.05);联合治疗组总有效率为89.13%,明显高于对照组(39.13%),差异有统计学意义(P<0.05)。结论阿托伐他汀联合阿魏酸钠治疗糖尿病肾病临床疗效显著,可有效延缓肾间质纤维化的速度,从而改善肾脏功能,值得临床推广应用。
Objective To investigate the clinical efficacy of atorvastatin combined with sodium ferulate in the treatment of diabetic nephropathy and its effect on renal interstitial fibrosis, to provide a clinical basis for the treatment of diabetic nephropathy. Methods 92 patients with diabetic nephropathy treated in Qinghai Fifth People’s Hospital from January 2014 to January 2016 were randomly divided into control group and combination therapy group, with 46 cases in each group. The changes of blood glucose and renal function before and after treatment were compared between the two groups and the clinical efficacy of the two groups after treatment. SPSS 17.0 software t test and χ ~ 2 test. Results After treatment, the serum levels of tumor growth factor-β (TGF-β), tumor necrosis factor-α (Ⅳ) and tumor necrosis factor-α Collagen (CⅣ) and type Ⅲ procollagen (PCⅢ) were significantly lower than those in the control group (P <0.05), and the decrease in the combined treatment group was significantly greater than that in the control group (P <0.05). The fasting blood glucose ), 2 h postprandial plasma glucose (2 h PG) levels were significantly lower than those before treatment. The indexes related to renal function were blood urea nitrogen (BUN), serum creatinine (SCr), 24 h urine albuminuria (UAER) Microglobulin (β_2-MG) and glomerular filtration rate (GFR) were significantly lower than before treatment, and the combined treatment group decreased significantly more than the control group, the difference was statistically significant (P <0.05); combination therapy The total effective rate was 89.13%, significantly higher than the control group (39.13%), the difference was statistically significant (P <0.05). Conclusion Atorvastatin combined with sodium ferulate for the treatment of diabetic nephropathy significant clinical efficacy, can effectively delay the speed of renal interstitial fibrosis, thereby improving renal function, deserved clinical application.