鄧婷婷　張紅　蒙艷

[摘要] 目的 觀察瑞格列奈聯(lián)合阿托伐他汀治療糖尿病腎病的臨床療效。方法 選取2016年1月—2017年7月期間于廣西醫(yī)科大學(xué)第四附屬醫(yī)院內(nèi)分泌科就診治療的糖尿病腎病患者120例作為研究樣本，按照隨機(jī)數(shù)字表法分為觀察組和對(duì)照組，每組60例，其中對(duì)照組患者給予瑞格列奈口服治療，觀察組患者在此基礎(chǔ)上加以阿托伐他汀口服治療。兩組療程均為12周，期間比較并記錄兩組患者各項(xiàng)血脂和腎功能指標(biāo)水平。結(jié)果 血脂指標(biāo)方面，治療前兩組患者高密度脂蛋白膽固醇（HDL-C）和低密度脂蛋白膽固醇（LDL-C）均無(wú)明顯區(qū)別（P>0.05）；治療后觀察組的HDL-C水平明顯高于對(duì)照組（P<0.05），而LDL-C水平則明顯低于對(duì)照組（P<0.05）。腎功能指標(biāo)方面，治療前，兩組患者的尿清蛋白肌酐比值（ACR）、腎小球?yàn)V過(guò)率（GFR）和胱抑素C（Cys C）均無(wú)明顯區(qū)別（P>0.05）；治療后觀察組的ACR和Cys C水平顯著低于對(duì)照組（P<0.05），而GFR水平則顯著高于對(duì)照組（P<0.05）。結(jié)論 瑞格列奈聯(lián)合阿托伐他汀治療糖尿病腎病，可有效改善患者各項(xiàng)血脂指標(biāo)和腎功能指標(biāo)，療效顯著，值得臨床上優(yōu)化推廣。

[關(guān)鍵詞] 瑞格列奈；阿托伐他??；糖尿病腎病；血脂；腎功能

[中圖分類號(hào)] R587.1 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1672-4062（2017）10（b）-0013-03

[Abstract] Objective To observe the clinical curative effect of Repaglinide combined with atorvastatin in treatment of diabetic nephropathy. Methods 120 cases of patients with diabetic nephropathy admitted and treated in our hospital from January 2016 to July 2017 were selected as the research samples， and randomly divided into two groups with 60 cases in each， the control group took the repaglinide orally， while the observation group took the atorvastatin orally on the basis of the control group， and the treatment course was 12 weeks， and various blood liquid and renal function level of the two groups were recorded and compared. Results The differences in the HDL-C and LDL-C between the two groups before treatment were not obvious（P>0.05）， after treatment， the HDL-C level in the observation group was obviously higher than that in the control group（P<0.05）， and the LDL-C level was obviously lower than that in the control group（P<0.05）， before treatment， the differences in the ACR， GFR and Cys C between the two groups were not obvious（P>0.05）， after treatment， the ACR and Cys C levels in the observation group were obviously lower than those in the control group（P<0.05）， but the GFR level was obviously higher than that in the control group（P<0.05）. Conclusion The repaglinide combined with atorvastatin in treatment of diabetic nephropathy can effectively improve various blood liquid and renal function and the curative effect is obvious， which is worth clinical promotion.

[Key words] Repaglinide； Atorvastatin； Diabetic nephropathy； Blood liquid； Renal function

作為最嚴(yán)重的一種糖尿病微血管并發(fā)癥，糖尿病腎病（dabetic nephropath， DN）同時(shí)也是終末期腎病發(fā)生的主要原因，死亡率較高，嚴(yán)重危害著患者的生活質(zhì)量和生命安全[1]。瑞格列奈，是近年來(lái)成功開(kāi)發(fā)的糖尿病腎病有效藥物，憑借著其起效快、藥效久和控制血糖良好等優(yōu)點(diǎn)得到廣泛應(yīng)用[2]。然而，代謝紊亂是導(dǎo)致DN惡化的又一主要原因，因此，除控制血糖水平以外，有效改善血脂異常對(duì)治療糖尿病腎病同樣重要。他汀類藥物調(diào)節(jié)血脂和抗氧化能力顯著，可有效改善糖尿病腎病患者各項(xiàng)血脂指標(biāo)和腎功能指標(biāo)，從而延緩病情發(fā)展。該文選擇該院2016年1月—2017年7月收治的120例DN患者為研究對(duì)象，旨在觀察瑞格列奈聯(lián)合阿托伐他汀治療糖尿病腎病的臨床療效，探討其調(diào)節(jié)血脂水平和改善腎功能的能力，結(jié)果表明該用藥方案效果理想，值得臨床上進(jìn)一步推廣應(yīng)用，現(xiàn)報(bào)道如下。