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目的评估超高剂量的厄贝沙坦对显性糖尿病肾病患者蛋白尿和肾功能的影响。方法选取2009年1月—2012年12月参与前瞻性非随机对照实验的糖尿病肾病患者40例,每天厄贝沙坦600mg为基础的综合疗法治疗并且随访3年。治疗前和治疗结束时,对比分析治疗前和治疗后肾功能、生化各项指标变化。结果随访结束时,收缩压和舒张压显著下降(P<.001)。血肌酐增加0.17mg/dl(P<0.05)。尿蛋白从(2.64±1.99)下降到(0.98±1.18)g/24h(P<0.001)。随访结束时,25%患者的尿白蛋白正常。血钾水平在试验过程保持相对稳定。结论超高剂量的厄贝沙坦能有效治疗显性糖尿病肾病,可以有效的控制好血压,有效降低蛋白尿并延缓其进展为终末期肾病。
Objective To evaluate the effect of ultra-high dose irbesartan on proteinuria and renal function in patients with dominant diabetic nephropathy. Methods Forty patients with diabetic nephropathy who participated in prospective non-randomized controlled trials from January 2009 to December 2012 were treated with irbesartan 600 mg daily for 3 years. Pre-treatment and end of treatment, comparative analysis of changes in renal function, biochemical indicators before and after treatment. Results At the end of follow-up, systolic and diastolic blood pressure decreased significantly (P <.001). Serum creatinine increased by 0.17 mg / dl (P <0.05). Urine protein decreased from (2.64 ± 1.99) to (0.98 ± 1.18) g / 24h (P <0.001). At the end of follow-up, 25% of patients had normal urinary albumin. Plasma potassium levels remained relatively stable during the test. Conclusion Ultra-high dose of irbesartan can effectively treat diabetic nephropathy, which can effectively control blood pressure, reduce proteinuria and delay its progression to end stage renal disease.