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| Efficacy of Irbesartan Combined with Enhanced External Counterpulsation in the Elderly Patients with Early Diabetic Nephropathy |
| LIUChun-tian, WANGXiao-juan, FENGJian-jun |
| Department of Geriatrics,The Second Affiliated Hospital of Xi'an Jiao Tong University , Xi'an, Shaanxi, 710004,China |
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Abstract 【Objective】 To investigate the efficacy of irbesartan combined with enhanced external counterpulsation in the treatment of senile early diabetic nephropathy (DN) and its effect on endothelial cell function.【Methods】 A total of 90 elderly patients with early diabetic nephropathy treated in our hospital were selected and randomly divided into the control group(45 cases)and the observation group(45 cases). Patients in the control group received routine hypoglycemic and lipid-lowering treatment plus a daily 150 mg irbesartan administered orally. Meanwhile, the observation group was given enhanced external counterpulsation (once daily for 45 minutes) on the basis of the conventional treatment received by the control group.All patients were treated for 8 weeks. The changes of serum creatinine (Scr), blood urea nitrogen (BUN), microalbuminuria (MA), beta2 microglobulin (β2-MG), N acetyl D glucosamine enzyme (NAG), serum cystatin C (Cys-C), endothelin -1 (ET-1) and nitric oxide (NO) were compared between the two groups before and after treatment.【Results】 After treatment, the levels of SCr, BUN, MA, β2-MG, NAG, and Cys-C in the blood of both groups' patients were decreased; the decrease in the observation group was significantly lower than in the control group (P<0.05). The level of ET-1 in the observation group after treatment was significantly lower than that before treatment, and it was lower than that of the control group as well (P<0.05).The level of NO in the observation groups was significantly higher than that in the control group before treatment. The difference was statistically significant (P<0.05). 【Conclusion】 Irbesartan combining with enhanced external counterpulsation in the treatment of elderly patients with DN can effectively reduce the excretion of urinary protein and improve renal function.The mechanism may be related to the improvement of endothelial cell function.
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Received: 24 October 2016
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2018, Vol. 35 
