目的 司維拉姆聯(lián)合依帕司他治療糖尿病腎病的臨床效果。方法 選擇2013年1月-2015年12月榆林市第二醫(yī)院收治的83例糖尿病腎病患者，隨機(jī)分為兩組。兩組均采取血液透析治療，對(duì)照組口服依帕司他治療，每次50 mg，每天3次；觀察組在對(duì)照組基礎(chǔ)上聯(lián)合服用司維拉姆治療。兩組均治療3個(gè)月。檢測兩組治療前后的炎性指標(biāo)、脂代謝指標(biāo)、血鈣和血磷，并進(jìn)行2年的隨訪。結(jié)果 觀察組治療后的腫瘤壞死因子-α（TNF-α）、白細(xì)胞介素-6（IL-6）、C反應(yīng)蛋白（CRP）、低密度脂蛋白膽固醇（LDL-C）、總膽固醇（TC）、三酰甘油（TG）、甲狀旁腺激素（iPTH）和血磷明顯低于治療前，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；對(duì)照組治療前后的各臨床檢測指標(biāo)相比均無明顯的差異；觀察組的冠狀動(dòng)脈鈣化率明顯低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組的2年生存率以及心血管事件病死率相比均無明顯的差異。結(jié)論 司維拉姆聯(lián)合依帕司他可以有效抑制糖尿病腎病患者的炎癥反應(yīng)，調(diào)節(jié)血脂水平，改善血管鈣化情況，降低冠狀動(dòng)脈鈣化發(fā)生率，有助于改善患者的預(yù)后。

Objective To study the clinical efficacy of sevelamer combined with epalrestat in the treatment of diabetic nephropathy. Methods Selected 83 cases of patients with diabetic nephropathy who were treated in our hospital from January 2013 to December 2015, divided into two groups randomly. The two groups were treated with hemodialysis, the control group was treated with oral epalrestat and the observation group was combined with sevelamer.Results After treatment, TNF-α, IL-6, LDL-C, CRP, TC, TG, iPTH and blood phosphorus were significantly lower than those before treatment (P<0.05), and there was no significant difference in the clinical test indexes before and after treatment in the control group. The rate of coronary artery calcification in the observation group was significantly lower than that of the control group (P<0.05). There was no significant difference in the 2 year survival rate between the two groups and the mortality of the cardiovascular events. Conclusion Sevelamer combined with epalrestat can effectively inhibit the inflammatory response in patients with diabetic nephropathy, regulate blood lipid levels, improve vascular calcification, reduce the incidence of coronary artery calcification, and help to improve the prognosis.