替米沙坦联合舒洛地特治疗糖尿病肾病Ⅲ期临床观察[摘要]目的探究替米沙坦?合舒洛地特治疗糖尿病肾病的临床效果。方法选取2015年3月～2017年3月我院收治的64例糖尿病肾病Ⅲ期患者作为研究对象，采用随机数字表法将其分为对照组和研究组，每组各32例。两组患者均接受常规治疗，对照组患者在常规治疗的基础上加服替米沙坦，研究组患者在常规治疗的基础上联用替米沙坦和舒洛地特，两组患者均治疗8周。比较两组患者的治疗总有效率以及治疗前和治疗8周时的血清肌酐（Scr）、尿素氮（BUN）、尿蛋白排泄率（UAER）、超敏C-反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）含量。结果研究组患者的治疗总有效率（93.75%）高于对照组（68.75%），差异有统计学意义（P<0.05）。治疗前，两组患者的Scr、BUN、UAER比较，差异无统计学意义（P>0.05）。治疗后，两组患者的UAER明显低于治疗前，研究组患者的UAER明显低于对照组，差异均有统计学意义（P<0.05）。治疗前，两组患者的hs-CRP、TNF-α含量比较，差异无统计学意义（P>0.05）。治疗后，两组患者的hs-CRP、TNF-α含量均明显低于治疗前，研究组患者的hs-CRP、TNF-α含量均明显低于对照组，差异有统计学意义（P<0.05）。结论替米沙坦联合舒洛地特治疗糖尿病肾病临床效果显著，明显优于单用替米沙坦，建议临床上推广应用。[关键词]替米沙坦；舒洛地特；糖尿病肾病；临床观察[]R654.2[文献标识码]A[]1674-4721（2018）2（b）-0126-03ClinicalobservationofTelmisartancombinedwithSulodexidefordiabetickidneydiseaseatstageⅢFANGHai-mingDepartmentofNephrology，KangmeiHospitalinPuningCity，GuangdongProvince，Puning515300，China[Abstract]ObjectiveToinvestigatetheclinicalefficacyofTelmisartancombinedwithSulodexideinthetreatmentofdiabeticnephropathy.Methods64patientswithdiabetickidneydiseaseatstageⅢtreatedinourhospitalfromMarch2015toMarch2017wereselectedassubjectsofthisstudy.Theyweredividedintocontrolgroupandstudygroupwithrandomnumbertablemethod，32casesineachgroup.Twogroupsofpatientsweretreatedwithconventionaltherapy，thepatientsofcontrolgroupweregivenTelmisartanontheadditionofconventionaltreatment，thepatientsofstudygroupweregivenTelmisartanandSulodexideonthebasisofconventionaltreatment，allpatientsweretreatedfor8weeks.Thetotaleffectiverateoftreatment，theserumcreatinine（Scr），ureanitrogen（BUN），microprojectionrate（UAER），highsensitivityC-reactiveprotein（hs-CRP）andtumornecrosisfactor-α（TNF-α）beforeandafter8weeksoftreatmenwerecomapredbetweentwogroups.ResultsThetotaleffectiverateinthestudygroup（93.75%）washigherthanthatinthecontrolgroup（68.75%），andthedifferencewasstatisticallysignificant（P<0.05）.TherewasnosignificantdifferenceintheScr，BUNandUAERbetweenthetwogroupsbeforetreatment（P>0.05）.Aftertreatment，theUAERinbothgroupswerelowerthanbeforetreament，theUAERinthestudygroupwassignificantlylowerthanthatinthecontrolgroup，andthedifferencewasstatisticallysignificant（P<0.05）.Beforetreatment，therewasnostatisticallysignificantdifferenceinhs-CRPandTNF-αinthetwogroups（P>0.05）.Aftertreatment，thelevelsofhs-CRPandTNF-αinbothgroupsweresignificantlylowerthanbeforetreatment，andthelevelsofhs-CRPandTNF-αinthestudygroupweresignificantlylowerthanthoseinthecontrolgroup，andthedifferenceswerestatisticallysignificant（P<0.05）.ConclusionTheefficacyofTelmisartancombinedwithSulodexideinthetreatmentofdiabetickidneydiseaseissignificantlybetterthanthatoftelmisartanalone，anditisrecommendedtobewidelyusedclinically.[Keywords]Telmisartan；Sulodexide；Diabetickidneydisease；Clinicalobservation糖尿病肾病（diabetickidneydisease，DKD）是临床上发病率较高的一...