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目的观察胰激肽原酶不同给药方式治疗糖尿病肾病蛋白尿的效果。方法将91例糖尿病肾病患者随机分为A、B、C、D四组。四组均给予低盐、低蛋白糖尿病饮食,控制血糖、血压达到良好水平。在此基础上A组口服胰激肽原酶,B组每日肌内注射胰激肽原酶,C组隔日肌内注射胰激肽原酶,D组连续肌内注射胰激肽原酶10d后改为口服;观察四组患者治疗前、治疗后4周24h尿蛋白、血尿素氮(BUN)、血肌酐(Scr)变化情况,以及不良反应发生情况。结果四组患者24h尿蛋白在治疗后均降低,B、D组与A、C组对比,24h尿蛋白、BUN和Scr降低更明显,差异显著(P(0.05),有统计学意义。B、D组在24h尿蛋白、BUN和Scr降低程度对比无明显差异(P(0.05),无统计学意义。结论胰激肽原酶肌内注射10d后改为口服的给药方式能明显降低糖尿病肾病蛋白尿,保护肾功能,且疗效成本低,患者易接受,值得临床推广使用。
Objective To observe the effect of different administration of pancreatic kininogenase on proteinuria of diabetic nephropathy. Methods 91 patients with diabetic nephropathy were randomly divided into four groups: A, B, C and D. Four groups were given low-salt, low-protein diet, blood sugar control, blood pressure reached a good level. On this basis, group A was given pancreatic kallikrein, group B was intramuscularly injected with kallikrein, group C was injected with kallikrein every other day, group D was intramuscularly injected with pancreatic kininogenase for 10 days And then changed to oral. The changes of urinary protein, blood urea nitrogen (BUN), serum creatinine (Scr) and the incidence of adverse reactions in the four groups before treatment and 4 weeks after treatment were observed. Results 24h urinary protein in all four groups decreased after treatment, while the levels of urinary protein, BUN and Scr in 24h in group B and group D were significantly lower than those in group A and C. The difference was significant (P <0.05) There was no significant difference in the level of urinary protein, BUN and Scr between group D and group D (P (0.05), P <0.05) .Conclusion Administration of pancreatic kininogenase to oral administration 10 d after intramuscular injection can significantly reduce diabetic nephropathy Proteinuria, renal function protection, and the effect of low cost, the patient is easy to accept, worthy of clinical promotion and use.