Clinical efficacy and safety of mecobalamin combined with folic acid in the treatment of type 2 diabetic nephropathy with high serum homocysteine

Abstract

Objective To investigate the clinical efficacy and safety of mecobalamin combined with folic acid in the treatment of type 2 diabetic nephropathy(DN) with high serum homocysteine. Methods From August 2015 to July 2016, a retrospective analysis of 70 patients with type 2 DN with high Hcy levels in our hospital were divided into two groups, 35 cases in each group. Control group underwent conventional western medicine comprehensive treatment (short-acting insulin injections, hydrochloric acid that captopril and valsartan tablets) for 52 weeks, the observation group received combined therapy with folic acid, cobalt amine on the basis of control group for 52 weeks. Clinical curative effect, the 24 h urine protein quantitative (24 h Pro) before and after treatment, blood levels of Hcy and security in two groups were compared. Results The total effective rate in the observation group was , higher than that in the control group (88.6% vs.77.1%, P<0.05). In the observation group, 24 h Pro at 12, 20, 36 and 52 weeks after treatment was (1135.76±175.69) mg/24 h, (831.02±165.71) mg/24 h, (423.14±102.93) mg/24 h, (165.05±73.36) mg/24 h, respectively.They were all lower than the control group (1524.83± 183.24) mg/24 h, (1057.69±143.35) mg/24 h, (785.68±114.39) mg/24 h, (423.17±109.27) mg/24 h (P<0.05). Blood Hcy of the observation group at 12, 20, 36 and 52 weeks after treatment was (18.25± 1.13) μmol/L, (14.32±1.22) μmol/L, (10.53±1.09) μmol/L, (6.15±1.15) μmol/L, (19.58±1.31) μmol/L, (16.31±1.18) μmol/L, (12.67±1.09) μmol/L(P<0.05), respectively. No serious adverse drug reactions occurred in either group. Conclusions The treatment of DN with high Hcy with addition of mecobalamin and folic acid has a definite clinical effect, which is helpful to reduce the level of blood Hcy in order to reduce the excretion of urinary protein, and the treatment is safe and reliable. Key words: Diabetic Nephropathies; Hyperhomocysteinemia; Vitamin B 12; Folic Acid