中国循证医学杂志

中国循证医学杂志

伟素治疗微量白蛋白尿期糖尿病肾病的疗效

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目的 探讨伟素对微量白蛋白尿期糖尿病肾病的疗效。
方法 纳入年龄43~70 岁,糖尿病病程6 个月~30 年,24 h 尿白蛋白排泄率(UAER)30 ~ 300 mg 的60例。微量白蛋白尿期糖尿病肾病(DN)患者 60 例,采用计算机随机分组方法将患者等分为 3 组:常规治疗组只予常规降糖治疗 12 周;氯沙坦钾组在常规降糖治疗同时每日晨口服氯沙坦钾 50 mg,12 周;伟素组在常规降糖治疗的同时给予伟素 600 LSU,qd, iv 或 im 治疗4周,再以250 LSU bid,po序贯治疗 8 周。所检测指标包括尿白蛋白排泄率(UAER)、尿素氮(BUN)、肌酐(Cr)等。
结果 常规治疗组 UAER 在治疗前后差异无统计学意义(Pgt;0.05)。而氯沙坦钾组和伟素组两组治疗前后差异有统计学意义(Plt;0.01),治疗 3 个月后氯沙坦钾组 UAER 下降 34.04%,伟素组下降 33.62%。治疗后两组 UAER 与常规组比较差异有统计学意义(Plt;0.01),但两组间同期比较差异无统计学意义(Pgt;0.05)。
结论 伟素能够减少微量白蛋白尿期糖尿病肾病患者的尿白蛋白排泄率;与氯沙坦钾的疗效相当。

Objective To assess the therapeutic effect of sulodexide for diabetic patients with early nephropathy.
Methods A total of 60 patients with early diabetic nephropathy (albuminuria: 30 to 300 mg/24 h, male/female: 30/30, mean age: 51.23 years, mean course of disease: 12.9 years) were randomized equally into three groups: the routine treatment group, cozaar group (50 mg qd, po for 12 weeks) and sulodexid group (600 LSU qd, iv or im for 4 weeks, 250 LSU bid, po for 8 weeks). The levels of urinary albumin excretion rate (UAER), urea nitrogen and creatinine were determined.
Results After three months of treatment, the level of UAER was decreased significantly in both the sulodexide group and cozaar group (Plt;0.01), but not in the routine treatment group (Pgt;0.05). The level of UAER was reduced by 34.04% and 33.62% in the cozaar group and the sulodexide group, respectively. Significant difference was noted in the level of UAER between the cozaar/sulodexide groups and the routine treatment group (Plt;0.01), but no significant difference was observed between cozaar group and sulodexide group (Pgt;0.05).
Conclusion Sulodexide could decrease the level of UAER in patients with early diabetic nephropathy. It has similar efficacy to cozaar.

关键词: 伟素; 糖尿病肾病; 微量白蛋白尿; 尿白蛋白排泄率; 随机对照试验

Key words: Sulodexide; Diabetic nephropathy; Microalbuminuria; Urinary albumin excretion rate; Randomized controlled trial

引用本文: 陈思娇,魏敏,高阳,胡怡,熊盈,张绍维,时景璞,李廷富,宋今丹. 伟素治疗微量白蛋白尿期糖尿病肾病的疗效. 中国循证医学杂志, 2008, 08(3): 162-166. doi: 10.7507/1672-2531.20080037 复制

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