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目的探讨硫辛酸联合氯沙坦治疗糖尿病肾病的疗效。方法 90例Ⅳ期糖尿病肾病患者随机分为3组,每组30例。硫辛酸组予以硫辛酸900 mg.d-1,氯沙坦组予氯沙坦100 mg.d-1,联合用药组硫辛酸900 mg.d-1+氯沙坦100 mg.d-1治疗,疗程均为12 wk。治疗前后检测24 h尿清蛋白、β2-微球蛋白(β2-MG)定量和血8-异前列腺素F2α(8-iso-PGF2α)水平。结果治疗后3组24 h尿清蛋白、β2-MG和血8-iso-PGF2α均降低,与治疗前比较差异非常显著(P<0.01)。硫辛酸组下降幅度大于氯沙坦组(P<0.05),联合用药组下降幅度大于氯沙坦组和硫辛酸组(P<0.05)。3组均无严重不良反应发生。结论硫辛酸联合氯沙坦治疗糖尿病肾病可以抗氧化应激,降低尿蛋白,疗效优于单药治疗。
Objective To investigate the efficacy of lipoic acid combined with losartan in the treatment of diabetic nephropathy. Methods Ninety patients with stage Ⅳ diabetic nephropathy were randomly divided into three groups (n = 30 in each group). Lipoic acid group was given lipoic acid 900 mg.d-1, losartan group losartan 100 mg.d-1, combined with lipoic acid 900 mg.d-1 + losartan 100 mg.d-1 treatment , Treatment is 12 wk. The levels of urinary albumin, β2-microglobulin (β2-MG) and 8-iso-PGF2α in 24 hours were measured before and after treatment. Results After 24 hours of treatment, the urinary albumin, β2-MG and 8-iso-PGF2α in 24 hours were significantly lower than those before treatment (P <0.01). The decrease in lipoic acid group was greater than that in losartan group (P <0.05), and that in combination group was greater than that in losartan group and lipoic acid group (P <0.05). No serious adverse reactions occurred in the three groups. Conclusion Lipoic acid combined with losartan in the treatment of diabetic nephropathy can be anti-oxidative stress, reduce urinary protein, the effect is superior to monotherapy.