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目的探讨缬沙坦用于胰岛素强化治疗早期糖尿病肾病的疗效和不良反应。方法 92例早期糖尿病肾病患者随机分为观察组(n=46)和对照组(n=46),均接受胰岛素强化治疗控制血糖,观察组接受缬沙坦胶囊一日1次80 mg,对照组接受除血管紧张素转化酶抑制剂(ACEI)和其他血管紧张素受体阻断剂(ARB)外的其他口服降压药,疗程均为12周,比较两组患者治疗前后的血压、血糖、血肌酐、尿白蛋白排泄率和24 h尿蛋白总量。结果治疗12周后两组患者的血压、空腹和餐后2 h血糖、糖化血红蛋白、血肌酐、尿白蛋白排泄率和24 h尿蛋白总量均下降(P<0.05,P<0.01)。与对照组治疗后相比,观察组血肌酐、尿白蛋白排泄率和24 h尿蛋白总量下降(P<0.05)。与对照组相比,观察组未出现严重不良反应。结论缬沙坦用于接受胰岛素强化治疗的早期糖尿病肾病患者可安全有效地控制血糖水平,并可改善患者肾功能。
Objective To investigate the efficacy and adverse reactions of valsartan in the treatment of early diabetic nephropathy with insulin. Methods Ninety-two patients with early diabetic nephropathy were randomly divided into observation group (n = 46) and control group (n = 46), receiving insulin intensive therapy to control blood glucose. The observation group received valsartan capsules 80 mg once daily and control group Received oral antihypertensive drugs in addition to angiotensin-converting enzyme inhibitors (ACEIs) and other angiotensin receptor blockers (ARBs) for 12 weeks. The blood pressure, blood glucose, Serum creatinine, urinary albumin excretion rate and 24 h urinary protein. Results After 12 weeks of treatment, blood pressure, fasting and 2 h postprandial blood glucose, glycosylated hemoglobin, serum creatinine, urinary albumin excretion rate and 24 h urinary protein content decreased (P <0.05, P <0.01). Compared with the control group, the serum creatinine, urinary albumin excretion rate and 24 h urinary protein in the observation group decreased (P <0.05). Compared with the control group, the observation group did not appear serious adverse reactions. Conclusions Patients with early diabetic nephropathy treated with valsartan for intensive insulin therapy can safely and effectively control their blood glucose levels and improve their renal function.