瑞格列奈联合阿托伐他汀治疗糖尿病肾病的临床疗效

邓婷婷　张红　蒙艳

[摘要] 目的 观察瑞格列奈联合阿托伐他汀治疗糖尿病肾病的临床疗效。方法 选取2016年1月—2017年7月期间于广西医科大学第四附属医院内分泌科就诊治疗的糖尿病肾病患者120例作为研究样本，按照随机数字表法分为观察组和对照组，每组60例，其中对照组患者给予瑞格列奈口服治疗，观察组患者在此基础上加以阿托伐他汀口服治疗。两组疗程均为12周，期间比较并记录两组患者各项血脂和肾功能指标水平。结果 血脂指标方面，治疗前两组患者高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）均无明显区别（P>0.05）；治疗后观察组的HDL-C水平明显高于对照组（P<0.05），而LDL-C水平则明显低于对照组（P<0.05）。肾功能指标方面，治疗前，两组患者的尿清蛋白肌酐比值（ACR）、肾小球滤过率（GFR）和胱抑素C（Cys C）均无明显区别（P>0.05）；治疗后观察组的ACR和Cys C水平显著低于对照组（P<0.05），而GFR水平则显著高于对照组（P<0.05）。结论 瑞格列奈联合阿托伐他汀治疗糖尿病肾病，可有效改善患者各项血脂指标和肾功能指标，疗效显著，值得临床上优化推广。

[关键词] 瑞格列奈；阿托伐他汀；糖尿病肾病；血脂；肾功能

[中图分类号] R587.1 [文献标识码] A [文章编号] 1672-4062（2017）10（b）-0013-03

[Abstract] Objective To observe the clinical curative effect of Repaglinide combined with atorvastatin in treatment of diabetic nephropathy. Methods 120 cases of patients with diabetic nephropathy admitted and treated in our hospital from January 2016 to July 2017 were selected as the research samples， and randomly divided into two groups with 60 cases in each， the control group took the repaglinide orally， while the observation group took the atorvastatin orally on the basis of the control group， and the treatment course was 12 weeks， and various blood liquid and renal function level of the two groups were recorded and compared. Results The differences in the HDL-C and LDL-C between the two groups before treatment were not obvious（P>0.05）， after treatment， the HDL-C level in the observation group was obviously higher than that in the control group（P<0.05）， and the LDL-C level was obviously lower than that in the control group（P<0.05）， before treatment， the differences in the ACR， GFR and Cys C between the two groups were not obvious（P>0.05）， after treatment， the ACR and Cys C levels in the observation group were obviously lower than those in the control group（P<0.05）， but the GFR level was obviously higher than that in the control group（P<0.05）. Conclusion The repaglinide combined with atorvastatin in treatment of diabetic nephropathy can effectively improve various blood liquid and renal function and the curative effect is obvious， which is worth clinical promotion.

[Key words] Repaglinide； Atorvastatin； Diabetic nephropathy； Blood liquid； Renal function

作為最严重的一种糖尿病微血管并发症，糖尿病肾病（dabetic nephropath， DN）同时也是终末期肾病发生的主要原因，死亡率较高，严重危害着患者的生活质量和生命安全[1]。瑞格列奈，是近年来成功开发的糖尿病肾病有效药物，凭借着其起效快、药效久和控制血糖良好等优点得到广泛应用[2]。然而，代谢紊乱是导致DN恶化的又一主要原因，因此，除控制血糖水平以外，有效改善血脂异常对治疗糖尿病肾病同样重要。他汀类药物调节血脂和抗氧化能力显著，可有效改善糖尿病肾病患者各项血脂指标和肾功能指标，从而延缓病情发展。该文选择该院2016年1月—2017年7月收治的120例DN患者为研究对象，旨在观察瑞格列奈联合阿托伐他汀治疗糖尿病肾病的临床疗效，探讨其调节血脂水平和改善肾功能的能力，结果表明该用药方案效果理想，值得临床上进一步推广应用，现报道如下。