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目的:观察低分子肝素联合ACEI/ARB治疗糖尿病肾病(DN)的疗效。方法:将55例2型DN患者随机分为对照组(ACEI/ARB)和治疗组(ACEI/ARB+低分子肝素),疗程8周。比较两组治疗前和治疗后24h尿蛋白,Scr、BUN、血浆白蛋白等指标的变化。结果:(1)治疗后治疗组和对照组24h尿蛋白、Scr均显著下降(P<0.01,P<0.05),治疗组比对照组下降更为明显(P<0.05)。(2)治疗后两组血浆白蛋白均增加(P<0.01),治疗组与对照组治疗后比较无明显差异(P>0.05)。(3)治疗后两组BUN均降低(P<0.05),治疗组与对照组治疗后比较无明显差异(P>0.05)。(4)治疗后两组TC和TG均无明显变化。结论:联合应用低分子肝素能有效减少DN患者的蛋白尿,改善肾功能。
Objective: To observe the therapeutic effect of low molecular weight heparin combined with ACEI / ARB on diabetic nephropathy (DN). Methods: 55 patients with type 2 DN were randomly divided into control group (ACEI / ARB) and treatment group (ACEI / ARB + LMWH) for 8 weeks. The changes of urinary protein, Scr, BUN, plasma albumin and other indexes before and 24 hours after treatment were compared between the two groups. Results: (1) After treatment, urinary protein and Scr of 24 h in treatment group and control group decreased significantly (P <0.01, P <0.05), and decreased more significantly in treatment group than in control group (P <0.05). (2) Plasma albumin increased in both groups after treatment (P <0.01). There was no significant difference between the treatment group and the control group after treatment (P> 0.05). (3) The BUN in both groups decreased after treatment (P <0.05), there was no significant difference between the treatment group and the control group after treatment (P> 0.05). (4) There was no significant change in TC and TG between the two groups after treatment. Conclusion: The combination of low molecular weight heparin can effectively reduce proteinuria in DN patients and improve renal function.