【摘要】 目的 观察舒洛地特联合缬沙坦治疗DN(Ⅳ期)的疗效。方法 86 例DN(Ⅳ期)患者常规治疗后随机分为两组，缬沙坦组口服缬沙坦胶囊，舒洛地特组口服缬沙坦胶囊，同时肌注舒洛地特注射液，2周后口服舒洛地特胶囊，共治疗3个月。检测治疗前后SBP、DBP、Scr、BUN、UA、血清光抑素C(cystatin C)、24 h尿钠排泄量、24 hUA1b、尿β2-微球蛋白(β2-MG)、尿α1微球蛋白(α1-MG)、尿N-乙酰-β-D葡萄糖苷酶(NAG)。结果 与治疗前相比，两组Cr、BUN、UA无明显变化(P>0.05)，SBP、DBP、血cystatin C、24 hUA1b、24 h 尿钠排泄量、尿α1-MG、β2-MG、NAG明显降低(P<0.05或P<0.01)。治疗后两组比较，舒洛地特组cystatin C、24 hUA1b、尿α1-MG、β2-MG、NAG降低明显(P<0.01)。 结论 舒洛地特联合缬沙坦治疗能更有效地降低DN患者的UA1b。

　　【关键词】 糖尿病,2型;糖尿病性肾脏疾病;舒洛地特;缬沙坦

　　Effect of sulodexide combined with valsartan on patients with diabetic nephropathy   WANG Ying, YAN Shu-xun, LV Jiu-sheng. Department of Gerontology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450008, China

　　Corresponding autuor: YAN Shu-xun, E-mail: ysx982001@163.com

　　【Abstract】Objective To observe the effect of the combination therapy of sulodexide and valsartan in patients with diabetic nephropathy (DN) in stage Ⅳ. Methods Eighty-six patients with DN were randomized into valsartan group and sulodexide group. The valsartan group was treated with oral valsartan capsule, and the sulodexide group received the combination therapy of valsartan capsule for oral taking together with sulodexide for muscular injection additionally, and 2 weeks later sulodexide capsule for oral takig, for 3 months. Then, the systolic blood pressure (SBP), diastolic blood pressure (DBP), serum creatinine (Scr), blood urea nitrogen (BUN), uric acid (UA), serum cystatin C, 24h natriuresis, 24h uric protein, urine β2-microglobulin (β2-MG), α1-microglobulin (α1-MG), and β-N-acetyglocosamidase (NAG) were measured. Results After treatment in the two groups, there were no significantly changes in Scr, BUN, and UA (P>0.05), the SBP, DBP, serum cystatin C, 24h uric protein, 24h natriuresis, urine α1-MG, β2-MG, and NAG were significantly decreased (P<0.05 or P<0.01), while the decrease in serum cystatin C, 24h uric protein, urine α1-MG, β2-MG, and NAG of the sulodexide group was more obvious (P<0.01). Conclusions Sulodexide combined with valsartan can decrease more effectively the uric protein, improving the renal function of T2DM patients with DN.

　　【Key words】Diabetic nephropathy (DN); Sulodexide; Valsartan