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目的:探讨胰激肽原酶联合血管紧张素Ⅱ受体拮抗剂(ARBs)对糖尿病肾病患者尿β2微球蛋白(β2-GM)和肾间质纤维化的影响。方法:选取2014年1月至2017年1月江苏昆山市第一人民医院收治的86例糖尿病肾病患者,随机分为研究组和对照组,每组43例。对照组在常规治疗的基础上给予ARBs治疗,研究组在对照组的基础上给予胰激肽原酶治疗。连续治疗8周后,观察两组血糖、肾功能、尿β2-GM水平及肾间质纤维化情况。结果:研究组血糖水平和肾功能明显优于对照组(P<0.01);研究组尿β2-GM水平、血清结缔组织生长因子(CTGF)和血清血管紧张素Ⅱ(AngⅡ)水平显著低于对照组(P<0.01)。结论:胰激肽原酶联合ARBs治疗糖尿病肾病,能够有效改善患者血糖水平和肾功能,同时能明显减少尿蛋白,延缓肾间质纤维化。
Objective: To investigate the effect of pancreatic kininogenase combined with angiotensin Ⅱ receptor antagonist (ARBs) on urinary β2-microglobulin (β2-GM) and renal interstitial fibrosis in patients with diabetic nephropathy. Methods: From January 2014 to January 2017, 86 patients with diabetic nephropathy admitted to First People’s Hospital of Kunshan City, Jiangsu Province were randomly divided into study group and control group, with 43 cases in each group. The control group was treated with ARBs on the basis of routine treatment. The study group was treated with pancreatic kininogenase on the basis of the control group. After 8 weeks of continuous treatment, the blood glucose, renal function, urine β2-GM level and renal interstitial fibrosis were observed. Results: The blood glucose level and renal function of the study group were significantly better than those of the control group (P <0.01). The levels of urinary β2-GM, CTGF and AngⅡ in the study group were significantly lower than those in the control group Group (P <0.01). Conclusions: Pancreatic kallikrein combined with ARBs in the treatment of diabetic nephropathy can effectively improve the blood sugar level and renal function of patients, and at the same time it can significantly reduce the urinary protein and delay the renal interstitial fibrosis.