α酮酸联合迈之灵治疗微量白蛋白尿的效果

摘要

Objective To explore the effect of α-keto acid combined with aescuven forte in treating microalbuminuria.Methods One hundred and seventy patients with microalbuminuria from January 2014 were randomly divided into control group (52 cases) without any drug therapy,single treatment group (72 cases) given alpha keto acid (5.04 g,2 times/day),and combined group (46 cases) given alpha keto acid (5.04 g,2 times/day) combined with aescuven forte (0.3 g,2 times/day),all the patients were required low protein diet (LPD);the treatment lasted for 12 weeks.The basic conditions of patients were recorded,including age,sex,body mass index (BMI),smoking or drinking,hypertension or diabetes mellitus.The level of urinary albumin were compared before and after treatment.Results The urinary albumin was influenced by alcohol,smoking,diabetes mellitus,hypertension (all P ＜0.05).Before treatment,the level of urinary albumin was not significantly different among three groups (P ＞ 0.05);12 weeks later,the levels of urinary albumin were all significantly reduced [control group:18.0 (6.7,43.2) mg/24 h vs 43.8 (37.6,48.3) mg/24 h,single treatment group:10.5 (2.5,12.6) mg/24 h vs 38.1 (35.7,44.8) mg/24 h and combined group:3.2 (2.1,6.2) mg/24 h vs 38.7 (35.5,47.5) mg/24 h] (P ＜ 0.05);the level of urinary albumin was significantly lower in single treatment group and combined group than that in control group,and was significantly lower in combined group than that in single treatment group (P ＜ 0.05).Conclusions Microalbuminuria is a sensitive indicator of early renal damage;based on low protein diet,alpha keto acid combined with aescuven forte can effectively control the microalbuminuria timely and reverse the impairment of renal function.%目的 探讨α酮酸联合迈之灵治疗微量白蛋白尿的效果.方法 选取2014年1-12月首都医科大学附属北京安贞医院泌尿外科门诊收治的微量白蛋白尿患者170例,完全随机分为对照组(52例)、单纯治疗组(72例)和联合治疗组(46例).所有患者采用基础治疗并遵循低蛋白饮食;对照组不予药物治疗;单纯治疗组采用α酮酸5.04g,2次/d治疗;联合治疗组采用α酮酸5.04g,2次/d联合迈之灵0.3g,2次/d治疗.对所有患者随访12周,记录治疗前患者基本情况,包括性别、年龄、体重指数、吸烟、饮酒、高血压、糖尿病等.比较治疗前和治疗12周后患者尿微量白蛋白水平.结果 尿微量白蛋白的发生受到高血压、糖尿病、饮酒、吸烟影响(均P＜0.05).治疗前,3组患者尿微量白蛋白水平差异无统计学意义(P＞0.05);治疗12周后,对照组、单纯治疗组及联合治疗组尿微量白蛋白水平均明显低于治疗前[18.0(6.7,43.2)mg/24h比43.8(37.6,48.3) mg/24 h、10.5 (2.5,12.6) mg/24 h比38.1 (35.7,44.8)mg/24 h、3.2(2.1,6.2) mg/24 h比38.7(35.5,47.5) mg/24 h],差异均有统计学意义(均P＜0.05);单纯治疗组及联合治疗组尿微量白蛋白水平均明显低于对照组,且联合治疗组低于单纯治疗组,差异均有统计学意义(均P ＜0.05).结论 尿微量白蛋白是肾脏损害早期的敏感指标,在低蛋白饮食基础上,应用α酮酸联合迈之灵长期口服,可及时控制尿微量白蛋白水平,疗效明显.