【摘要】　目的 观察阿法骨化醇联合替米沙坦治疗早期DN疗效。 方法　60例门诊及住院符合入选条件的DN患者随机分为单用阿法骨化醇组(0.25μg/d)、替米沙坦组(20~40mg/d)、阿法骨化醇(0.25μg/d)联合替米沙坦组(20~40mg/d) 进行治疗, 每组20例,血压均控制在125 /75 mm Hg以下,疗程12周, 治疗前后观察3组患者FBG、HbA1c、BP、24 hUAlb、BUN、血Cr、血钙、血钾等水平。 结果　3组治疗后24 hUAlb均下降( P<0. 05) ,联合用药组下降更明显( P<0. 01) 。其他指标变化差异无统计学意义 ( P>0.05)。60例患者治疗期间无明显不良反应。 结论　 阿法骨化醇和替米沙坦均能降低DN患者的尿蛋白，联合应用疗效更佳。

　　【关键词】糖尿病肾病; 阿法骨化醇;替米沙坦;治疗结果

　　Effect of combined therapy with Alfacacidol and Telmisartan on diabetic nephropathy in early stage　ZHOU Xue- hong, LIU Shu-yan, et al. Department of Endocrinology, Henan Jiaozuo the Second People\'s Hospital, Jiaozuo 454001, China

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　　【Abstract】Objective　To investigate the effect of combined therapy with Alfacalcidol and Telmisartan on the diabetic nephropathy in early stage.　Methods　The 60 diabetic nephropathy patients in our hospital were enrolled. They were randomly divided into three groups. Group A was treated by Alfacalcidol 0.25μg per day, Group B was treated by Telmisartan 20-40mg per day, and Group C was treated by Alfacalcidol 0.25μg and Telmisartan 20-40mg per day. The blood pressure of all the patients was controlled below 125/75mm Hg. The fasting blood glucose (FBG), HbA1c, BP, 24h urinary protein, urea nitrogen (BUN), serum creatinine (SCr), calcium (Ca2+), and potassium (K+) were measured before the experiment and 12 weeks later. Results The 24h urine protein in all the groups was decreased (P<0.05) after 12 weeks. Compared with group A and B, the 24h urine protein in group C was significantly decreased (P<0.01). There were no significant differences in other indices (P>0.05). There were no obvious adverse effects during the treatment in all groups. Conclusion Both Alfacalcidol and Telmisartan can reduce the urine protein excretion in diabetic nephropathy patients. But the combination therapy has additive efficacy.

　　【Key words】Diabetic nephropathy; Alfacalcidol; Telmisartan; Treatment outcome