氯沙坦联合卡托普利治疗早期糖尿病肾病的临床研究

目的探讨氯沙坦联合卡托普利治疗早期糖尿病肾病(DN)的临床疗效及安全性,为临床合理选择用药提供依据.方法88例2型糖尿病肾病患者随机分为3组,分别为氯沙坦组、卡托普利组及联合用药组,疗程均为24周.观察治疗前后各组收缩压(SBP)、舒张压(DBP)、尿白蛋白排泄率(UAER)、血尿素氮(BUN)、血肌酐(Cr)、糖化血红蛋白(HbA1c)、血钾(K )、血总胆固醇(CH)、甘油三酯(TG)变化.结果联合用药组、氯沙坦组和卡托普利组治疗早期DN,均有明显降压、降尿蛋白的作用,各组治疗前后比较差异有显著性(P＜0.01、P＜0.05);联合用药组舒张压降低程度与单独用药两组比较,差异有显著性(P＜0.05);联合用药组UAER降低幅度较氯沙坦组和卡托普利组明显,分别为59%、53%、50%;各组BUN、Cr、HbAlc、K 、CH、TG治疗前后及各组间比较无统计学意义(P＞0.05).结论氯沙坦联合卡托普利治疗早期糖尿病肾病更有效、更合理,并无明显不良反应.

Clinical study of losartan combined with captopril in patients with early diabetic nephropathy

Aim To evaluate the clinical efficacy and safety of losartan combined with captopril in patients with early diabetic nephropathy (DN), so as to provide the rationality of clinical medication. Methods Eighty-eight patients with DN were randomly divided into three groups: group A received losartan, group B captopril and group C losartan combined with captopril for 24 weeks. Systolic blood pressure (SBP), Diastolic blood pressure (DBP), urinary albumin excretion rate (UAER), serum BUN, Cr, Hb1Ac,potassium(K + ), CH and TG were observed. ResultsThere were significant differences (P<0.01,P<0.05) in decreasing BP and urinary protein after treatment among three groups. As compared with patients in group A and group B, blood diastolic pressure were decreased markedly in patients of group C(P<0.05). UAER were decreased markedly in group C, the decreasing rate was 59%,53%,50% respectively.There were no differences in serum levels of BUN, Cr, Hb1Ac, potassium, CH and TG after treatment among three groups(P>0.05). ConclusionLosartan combined with captopril was more effective and rational in treating patients with early DN without side effect.