目的 探討非奈利酮聯(lián)合厄貝沙坦治療糖尿病腎臟病的臨床療效。方法 選取2021年6月—2023年8月駐馬店市中心醫(yī)院收治的150例糖尿病腎病患者，依據(jù)用藥差異情況分為對照組和治療組，每組各75例。對照組患者口服厄貝沙坦片，150 mg/次，1次/d。在對照組的基礎(chǔ)上，治療組患者口服非奈利酮片，20 mg/次，1次/d。兩組均用藥30 d。觀察兩組患者的臨床療效，比較治療前后兩組患者臨床癥狀改善情況，血清肌酐（SCr）、血尿素氮（BUN）、血清糖原合酶激酶-3β（GSK-3β）、分泌型卷曲蛋白-4（SFRP-4）、轉(zhuǎn)化生長因子-β1（TGF-β1）、細(xì)胞間黏附分子-1（ICAM-1）水平。結(jié)果 治療后，對照組和治療組臨床總有效率分別為86.67%、96.00%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，治療組的肢體水腫、蛋白尿、乏力、面色蒼白等癥狀好轉(zhuǎn)時(shí)間均短于對照組（P＜0.05）。治療后，兩組腎功能指標(biāo)SCr、BUN和血清TGF-β1、SFRP-4、GSK-3β、ICAM-1水平均明顯降低（P＜0.05），且治療后治療組SCr、BUN、TGF-β1、SFRP-4、GSK-3β、ICAM-1水平均明顯低于對照組（P＜0.05）。結(jié)論 非奈利酮聯(lián)合厄貝沙坦治療糖尿病腎臟病對糖尿病腎病患者臨床癥狀有效改善，并能緩解腎功能狀態(tài)，促進(jìn)機(jī)體炎性反應(yīng)減弱。

Objective To explore the clinical effects of finerenone combined with irbesartan in treatment of diabetes nephropathy. Methods Patients (150 cases) with diabetes nephropathy in Zhumadian Central Hospital from June 2021 to August 2023 were selected and were divided into control and treatment group based on different treatments. Each group had 75 cases. Patients in the control group were po administered with Irbesartan Tablets, 150 mg/time, once daily. Patients in the treatment group were po administered with Finerenone Tablets on the basis of the control group, 20 mg/time, once daily. Patients in two groups were treated for 30 d. After treatment, the clinical evaluations were evaluated, the improvement of clinical symptoms, serum creatinine (SCr), blood urea nitrogen (BUN), and serum glycogen synthase kinase-3β (GSK-3β), secretory curly protein-4 (SFRP-4) and transforming growth factor-β1 (TGF-β1) and intercellular adhesion molecule (ICAM-1) in two groups before and after treatment were compared. Results After treatment, the clinical effective rates in the control group and the treatment group were 86.67% and 96.00% respectively, and the difference between two groups was statistically significant (P < 0.05). After treatment, the improvement time of clinical symptoms such as limb edema, proteinuria, fatigue and pale complexion was shorter than that in the control group (P < 0.05). After treatment, the levels of renal function indexes SCr and BUN and serum TGF-β1, SFRP-4, GSK-3β and ICAM-1 in two groups were significantly decreased (P < 0.05), and the SCr, BUN, TGF-β1, SFRP-4, GSK-3β and ICAM-1 in the treatment group was significantly lower than those in the control group (P < 0.05). Conclusion Finerenone combined with irbesartan in treatment of diabetes nephropathy can effectively improve the clinical symptoms of patients with diabetes nephropathy, can also alleviate renal function and promote the weakening of inflammatory response.

R983

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目（LHGJ20210413）