卡托普利联合坎地沙坦对糖尿病肾病患者的疗效及对血浆ET、D-D、Hcy、ADM、FIB水平的影响

目的:研究卡托普利联合坎地沙坦治疗糖尿病肾病患者的临床疗效及对血浆内皮素(Endothelin,ET)、D-二聚体(D-Dimer,D-D)、同型半胱氨酸(Homocysteine,Hcy)、肾上腺髓质素(Adrenal medulla,ADM)、纤维蛋白原(Fibrinogen,FIB)的影响。方法:选择2016年1月至2017年8月在我院治疗的糖尿病肾病患者72例,根据不同的治疗方法分为观察组和对照组。对照组采用卡托普利治疗,观察组在对照组的基础上联用坎地沙坦治疗,观察和比较两组患者的临床治疗效果,治疗前后ET、D-D、Hcy、ADM、FIB水平、肾功能及空腹血糖(fasting plasma glucose,FPG)、餐后2小时血糖浓度(2 hours Plas ma Glucose,2hPG)、糖化血红蛋白(Hemoglobin A1c,HbA1C)水平的变化。结果:治疗后,观察组总有效率为88.89%,明显高于对照组69.44%(P0.05);观察组血浆ET、D-D、Hcy、ADM、FIB、FPG、2hPG、HbA1C水平、24 h尿总蛋白及尿白蛋白排泄率均显著低于对照组(P0.05)。结论:卡托普利联合坎地沙坦治疗糖尿病肾病患者的临床疗效明显优于单用卡托普利治疗,可助于降糖、降压并有效保护患者肾脏功能。

Clinical Efficacy of Captopril Combined with Candesartan in the Treatment of Patients with Diabetic Nephropathy and Effects on the Plasma ET, D-D, Hcy, ADM and FIB Levels

ABSTRACT Objective: To study the clinical efficacy of captopril combined with candesartan in the treatment of patients with dia- betic nephropathy and effects on the plasma ET, D-D, Hcy, ADM and FIB levels. Methods: 72 cases of patients with diabetic nephropa- thy in our hospital from January 2016 to August 2017 were selected and randomly divided into the control group and the observation group. The The control group was treated with captopril. The observation group was treated with candesartan on the basis of the control group. The clinical effects of ET, D-D, Hcy, ADM, FIB, renal function and the changes of FPG, 2hPG and HbA1C before and after treat- ment were observed and compared between two groups. Results: After treatment, the total effective rate of the observation group was 88.89%, which was significantly higher than that of the control group(69.44%, P<0.05). The levels of ET, D-D, Hcy, ADM, FIB, FPG, 2hPG and HbA1C in the observation group were significantly lower than those in the control group (P<0.05). Conclusion: Captopril com- bined with candesartan in patients with diabetic nephropathy clinical efficacy was significantly superior to captopril alone can help hypo- glycemic, antihypertensive and effective protection of patients with renal function.