目的:研究来氟米特联合氯沙坦钾治疗对糖尿病肾病患者肾功能及肾小球足细胞损伤的影响.方法:选择在我院就诊的82例糖尿病肾病(CKDIIIa、IIIb期)患者作为研究对象,采用随机数表法分为来氟米特(LEF)组和对照组,分别接受来氟米特联合氯沙坦钾治疗和氯沙坦钾单药治疗.治疗前和治疗后8周时测定血清中肾功能指标、RAAS分子含量、炎性因子含量以及尿液中足细胞损伤蛋白含量.结果:治疗后8周时,两组血清中Scr、BUN、CysC、PRA、AT-II、ALD、IL-1β、IL-6、TNF-α含量、尿液中ACR水平以及podocalyxin、nephrin、CA2AP、podocin含量均显著低于治疗前且LEF组血清中Scr、BUN、CysC、IL-1β、IL-6、TNF-α含量、尿液中ACR水平以及podocalyxin、nephrin、CA2AP、podocin含量均显著低于对照组,血清中PRA、AT-II、ALD的含量与对照组比较无显著性差异.结论:来氟米特联合氯沙坦钾治疗能够改善糖尿病肾病患者的肾功能、抑制炎症反应对肾小球足细胞的损伤.%Objective: To study the effecof leflunomide combined with losartan potassium therapy on renal function and glomerulapodocyte injury in patientwith diabetinephropathy.Methods: total of 82 patientwith diabetinephropathy (CKDIIIa, IIIstage) who were treated in ouhospital between June 2013 and May 2016 were selected athe research subjects, random numbetable waused to divide them into leflunomide (LEF) group and control group who received leflunomide combined with losartan potassium therapy and losartan potassium monotherapy respectively.Before treatmenand 8 weekaftetreatment, serum contentof renal function indexes, RAAmoleculeand inflammatory factorawell aurine contentof podocyte damage proteinwere determined.Results: Eighweekaftetreatment, serum Scr, BUN, CysC, PRA, AT-II, ALD, IL-1β, IL-6 and TNF-α contents, urine AClevelawell apodocalyxin, nephrin, CA2AP and podocin contentof both groupof patientwere significantly lowethan those before treatment, and serum Scr, BUN, CysC, IL-1β, IL-6 and TNF-α contents, urine AClevel awell apodocalyxin, nephrin, CA2AP and podocin contentof LEF group were significantly lowethan those of control group, serum PRA, AT-II, ALD contenthad no significandifference with control group.Conclusions: Leflunomide combined with losartan potassium therapy can improve the renal function of patientwith diabetinephropathy, and inhibithe inflammatory response injury to glomerulapodocyte.
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