氯沙坦联合阿托伐他汀对糖尿病肾病内皮功能及血管弹性的影响

目的 观察氯沙坦联合阿托伐他汀对糖尿病肾病（diabetic nephropathy,DN）内皮功能及血管弹性的影响.方法 65例糖尿病肾病合并高血压患者,按照随机信封法分为3组：氯沙坦组,50 mg/d;阿托伐他汀组,20 mg/d;联合治疗组,氯沙坦50 mg/d＋阿托伐他汀20 mg/d.观察治疗6个月后肱动脉血流介导的血管舒张功能（FMD）和肱-踝动脉脉搏波速度（baPWV）的变化情况.结果 治疗6个月后,联合治疗组FMD为（10.61±0.52）,与氯沙坦组（7.28±0.59）或阿托伐他汀组（6.87±0.62）比较,差异有统计学意义（P＜0.05）;联合治疗组baPWV为（8.56±0.44） cm/s,与氯沙坦组（10.8±0.62） cm/s或阿托伐他汀组（11.2±0.41） cm/s比较,差异有统计学意义（P＜0.05）.结论 氯沙坦和阿托伐他汀联合使用有助于进一步改善DN血管内皮功能及动脉血管的弹性度.

Effect of losartan combined with atorvastatin on endothelial function and arterial elasticity in diabetic nephropathy

Objective To study the effects of losartan combined with atorvastatin on the endothelial function and arterial elasticily elasticity in patients with diabetic nephropathy. Methods A total of 65 patients with diabetic nephropathy were enrolled and randomized to losartan group （only losartan 50 mg/d） , atrovastatin group （only atorvastatin 20 mg/d） and combined group （losartan 50 mg/d ＋ atorvastatin 20 rag/d） by envelopes. The brachial artery flow-mediated dilation （FMD） and brachial-ankle pulse wave velocity （baPWV） were compared among the three groups during six-month follow-up. Results After six-month follow-up, the levels of FMD （10.61 ±0.52） and baPWV （8.56± 0.44 cm/s） in the combined group improved much more significantly than those in losartan group FMD： （7.28 ±0.59） ; baPWV： （10.8 ±0.62） cm/s] or atrovastatin group FMD： （6.87 ±0.62） ; baPWV： （11.2 ±0.41） cm/s ] （P 〈 0.05 ）. Conclusions Losartan combined with atorvastatin benefits the endothelial function and arterial elasticity in diabetic nephropathy.