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目的:探讨丹参注射液联合替米沙坦治疗对Ⅳ期糖尿病肾病(DN)患者Ⅳ型胶原(Col Ⅳ)和纤维连接蛋白(FN)的影响。方法:选取60例Ⅳ期DN患者,随机分为观察组和对照组各30例。对照组给予口服替米沙坦,观察组给予丹参注射液静滴联合口服替米沙坦,连续治疗2周。比较两组治疗前后空腹血糖(FBG)、尿蛋白排泄率(UAER)、肌酐(Cr)、血尿素氮(BUN)、Ⅳ型胶原(Col Ⅳ)、纤维连接蛋白(Fn)及血小板源性生长因子-B(PDGF-B)。结果:治疗后,观察组Col Ⅳ、Fn、PDGF-B及UAER显著低于对照组,组间比较,差异具有统计学意义(P<0.05);两组患者FBG、Cr及BUN比较,差异无统计学意义(P>0.05)。结论:丹参注射液联合替米沙坦治疗Ⅳ期DN可有效降低UAER,而拮抗DN所致的PDGF-B高表达,抑制Col Ⅳ及Fn分泌,可能是其发挥肾脏保护作用的主要机制。
Objective: To investigate the effect of Salvia miltiorrhiza injection combined with Telmisartan on Col Ⅳ and fibronectin (FN) in stage Ⅳ diabetic nephropathy (DN). Methods: Sixty patients with stage Ⅳ DN were randomly divided into observation group (30 cases) and control group (30 cases). The control group was given oral telmisartan. The observation group was treated with intravenous injection of telmisartan and Salvia miltiorrhiza injection for 2 weeks. The levels of fasting blood glucose (FBG), urinary protein excretion (UAER), creatinine (BUN), collagen Ⅳ (Ⅳ), fibronectin (Fn) and platelet derived growth Factor-B (PDGF-B). Results: After treatment, Col Ⅳ, Fn, PDGF-B and UAER in the observation group were significantly lower than those in the control group, the difference was statistically significant (P <0.05). There was no significant difference in FBG, Cr and BUN between the two groups Statistical significance (P> 0.05). Conclusion: Salvia miltiorrhiza injection combined with Telmisartan treatment of stage Ⅳ DN can effectively reduce UAER, and antagonize DN-induced high expression of PDGF-B and inhibit the secretion of Col Ⅳ and Fn, which may be its main mechanism of renal protection.