目的 探討來氟米特聯(lián)合氯沙坦鉀對糖尿病腎?。―N）患者腎小球足細(xì)胞的影響。方法 將60例DN患者隨機(jī)分為對照組與治療組各30例，對照組予氯沙坦鉀治療，50 mg/次口服，1次/d；治療組在對照組基礎(chǔ)上給予來氟米特治療，前3 d劑量為50 mg/次，1次/d，之后減量至20 mg/次，1次/d。兩組療程均為6周。分別在治療前后檢測血肌酐（Scr）、尿素氮（BUN）、24 h蛋白尿定量、尿足細(xì)胞數(shù)及其標(biāo)志蛋白（PCX）。結(jié)果 治療前，兩組Scr、BUN、24 h蛋白尿定量均無統(tǒng)計學(xué)差異；治療后，兩組Scr、BUN、24 h蛋白尿定量均較治療前明顯下降，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組以上指標(biāo)明顯低于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。治療前，兩組尿足細(xì)胞數(shù)和PCX水平比較，差異無統(tǒng)計學(xué)意義；治療后，兩組尿足細(xì)胞數(shù)和PCX水平較治療前明顯降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組明顯低于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。治療組總有效率為93.3%，明顯優(yōu)于對照組的73.3%，差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 來氟米特聯(lián)合氯沙坦鉀治療DN的療效較好，可有效減少腎小球足細(xì)胞的損傷。

Objective To investigate the effect of losartan potassium combined with leflunomide on glomerular podocyte in patients with DN.Methods 60 patients with DN were randomly divided into the control group and the treatment group with 30 cases in each group. The control group were treated with losartan potassium, and the treatment group were treated with losartan potassium combined with leflunomide. Serum creatinine (Scr), urea nitrogen (BUN), 24 h protein, urine podocyte number and its marker protein (PCX) were measured before and after treatment.Results The levels of Scr, BUN, 24 h, proteinuria, urine podocytes and PCX in the two groups were significantly lower than those before treatment (P < 0.05), and the treatment group were significantly lower than those of the control group (P < 0.05). The clinical curative effect of the treatment group was obviously superior to that of the control group (P < 0.05).Conclusions Losartan potassium combined with leflunomide is effective in the treatment of DN, and can effectively reduce the podocyte damage.