论文部分内容阅读
目的通过无创血管动脉硬化诊断系统检测高龄糖尿病肾病早期患者心脏-脚踝血管指数(CAVI),评估糖尿病肾病血管僵硬度,同时评估丹红注射液联合脑心通胶囊对血管僵硬度的改善情况。方法选取2013年2月~2015年12月于陆军总医院住院治疗的75岁以上糖尿病肾病早期病变患者90例,男性85例,女性5例。将其随机分为观察组(45例)和对照组(45例)。针对患者原发病给予严格的血糖控制。对照组在控制血糖治疗的基础上给予培哚普利;观察组在对照组基础上加用丹红注射液静脉滴注,同时给予脑心通胶囊。持续治疗2周后停丹红注射液,继续脑心通胶囊药物治疗6个月。记录患者治疗期间的不良反应。治疗前及治疗6个月后检测24 h的尿蛋白定量、CAVI变化。同时评价疗效。结果两组治疗后24 h尿蛋白定量改善情况,观察组显效8例、有效30例、无效7例,总有效率为84.44%;对照组显效6例、有效19例、无效20例,总有效率为55.56%。观察组总有效率明显高于对照组(84.44%vs.55.56%),差异具有统计学意义(P<0.05)。两组患者治疗后24 h尿蛋白定量和CAVI值均较治疗前有所下降,差异有统计学意义(P均<0.05)。与对照组治疗后比较,观察组24 h尿蛋白定量和CAVI值明显下降,[(0.45±0.07)g vs.(0.22±0.06)g],[(8.71±0.79)vs.(7.88±0.93)],差异有统计学意义(P均<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论高龄糖尿病肾病早期病变患者的血管僵硬度升高,经丹红注射液联合脑心通胶囊治疗后血管僵硬度改善,治疗有效率明显提高。心脏-脚踝血管指数检测可作为评估高龄糖尿病肾病患者血管状态的经济实用指标。
Objective To assess the vascular stiffness of diabetic nephropathy by assessing the cardio-ankle vascular index (CAVI) in patients with advanced diabetic nephropathy by noninvasive vascular atherosclerosis diagnostic system and evaluate the improvement of vascular stiffness by Danhong injection combined with Naoxintong capsule. Methods From February 2013 to December 2015, 90 patients with early stage diabetic nephropathy over 75 years old were enrolled in Army General Hospital, 85 males and 5 females. They were randomly divided into observation group (45 cases) and control group (45 cases). Strict glycemic control for patients with primary disease. The control group was given perindopril on the basis of the control of blood glucose. The observation group was given Danhong injection intravenously on the basis of the control group, while Naoxintong capsule was given. Continuous treatment for 2 weeks Dan Danhong injection, continue Naoxintong capsule drug treatment for 6 months. Record the patient’s adverse reaction during treatment. Before treatment and after 6 months of treatment, urinary protein and CAVI in 24 h were measured. At the same time evaluate the efficacy. Results After 24 hours of treatment, the urinary protein was quantitatively improved in two groups. The observation group was markedly effective in 8 cases, effective in 30 cases, ineffective in 7 cases, the total effective rate was 84.44%; in the control group, 6 cases were markedly effective, 19 cases were effective and 20 cases were ineffective. Efficiency is 55.56%. The total effective rate in observation group was significantly higher than that in control group (84.44% vs.5.5.56%), the difference was statistically significant (P <0.05). Urinary protein and CAVI in 24 hours after treatment in both groups were significantly lower than those before treatment (all P <0.05). Compared with the control group, urinary protein and CAVI in the observation group decreased significantly at 24 h ([(0.45 ± 0.07) g vs. (0.22 ± 0.06) g], [(8.71 ± 0.79) vs. (7.88 ± 0.93) ], The difference was statistically significant (P <0.05). Two groups of patients with adverse reactions, the difference was not statistically significant (P> 0.05). Conclusion The vascular stiffness of patients with advanced diabetic nephropathy in the early stage is increased. After the treatment of Danhong injection and Naoxintong capsule, the vascular stiffness is improved and the treatment efficiency is obviously improved. Cardiac-ankle vascular index test can be used as an economical and practical indicator for evaluating the vascular status of patients with advanced diabetic nephropathy.