摘要
评析应用小剂量螺内酯联合非布司他治疗早期糖尿病肾病合并高尿酸血症的临床效果,以期为临床提供指导性依据.方法 选择上海市复旦大学附属中山医院于2013年6月~2014年6月收治的206例早期糖尿病肾病伴合并高尿酸血症患者随机分为对照组和试验组2组,每组均为103例.2组均予以口服降糖药物或胰岛素控制血糖与低盐低脂优质低蛋白饮食等处理,对照组在此基础上给予小剂量螺内酯治疗,试验组同时合并非布司他治疗,疗程为24周.比较2组患者治疗前后疾病相关指标的差异.结果 试验组治疗后的UAER、HbAlc、SUA、TC、TG、全血黏度等较治疗前均显著下降(P<0.05),对照组各项指标治疗前后的差异无统计学意义;试验组治疗后UAER、SUA显著低于对照组(P<0.05)HbAlc、TC、TG、HDL-C、LDL-C、血液流变学指标组间比较均无统计学意义.结论 在控制血糖及饮食治疗的基础上,采用小剂量螺内酯联合非布司他治疗早期糖尿病肾病合并高尿酸血症,有助于纠正高尿酸血症,调节血糖、血脂紊乱、纠正血液流变性,并对肾具一定保护作用,值得临床重视并推广.
Abstract
Objective To ivaluate the effect of low dose spironolactone combined with febuxostat on the treatment of early diabetic nephropathy complicated with hyperuricemia, in order to provide guidance for clinical.Methods206 cases with early diabetic nephropathy complicated with hyperuricemia in Zhongshan hospital affiliated to Fudan University from June 2013 to June 2014, were randomly divided into the control group and the experimental group, 103 cases in each group.The 2 groups were treated with oral hypoglycemic drugs or insulin to control blood sugar, low salt, low fat and low protein diet.At this basis, the control group were treated with low dose of spironolactone, the experimental group were given low dose spironolactone combined with febuxostat, 24 weeks for a course of treatment.The disease related indexes in the two groups were compared before and after treatment.ResultsAfter treatment, the HbAlc, SUA, TC, TG, UAER and the whole blood viscosity were significantly decreased in the experimental group (P<0.05).There was no significant difference among the indexes in the control group before and after treatment.UAER and SUA in the experiment were lower than those in the control group after treatment (P< 0.05), and the differences of HbAlc, TC, TG, HDL-C, LDL-C and hemorheology index in the two groups were not statistically significant.ConclusionBased on the control of blood glucose and diet therapy, it can correct hyperuricemia, regulate blood sugar and blood lipid disorders, correct the hemorheological indexes, which low doses of spironolactone combined with febuxostat in treating early diabetic nephropathy complicated with hyperuricemia, it can protect renal function well, and it is worthy of attention and promotion.
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维普
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