ACEI联合ARB治疗糖尿病肾病的临床疗效分析

目的分析雷米普利联合替米沙坦治疗糖尿病肾病的临床疗效。方法收集临床糖尿病肾病患者210例,随机分成3组,每组70例,分别为雷米普利组、替米沙坦组、联合治疗组。治疗12周（1个疗程）后,比较以上3组患者的24小时尿微量白蛋白含量（UMA）、内生肌酐清除率（Ccr）、血尿素氮（BUN）、血清钾离子浓度、血压等临床生化指标。结果在UMA与血压方面,3组患者治疗前后均有显著性下降（P〈0.05）;而在Ccr、BUN及K＋浓度方面,3组患者治疗前后均无明显改变（P〉0.05）。与雷米普利组或替米沙坦组相比较,联合治疗组治疗后的UMA明显降低（P〈0.05）,而Ccr、BUN、血压及K＋浓度无明显改变（P〉0.05）。结论雷米普利联合替米沙坦是早期治疗糖尿病肾病较好的可选方案之一。

Clinical analysis of ACEI combined with ARB for diabetic nephropathy

Objective To analyze the clinical efficacy of ACEI combined with ARB for diabetic nephropathy.Methods Totally 210 patients with diabetic nephropathy were randomized into Ramipril group,Telmisartan group and combined treatment group equally（n=30）.After the 12 week＇s therapy（one course）,the data of urine minimal albumen（UmA）,creatinine clearance rate（CcR）,blood urea nitrogen（BUN）,potassium ion concentration in serum（K＋） and blood pressure were analyzed and compared among the three groups.ResultsSignificant decreases in the level of blood pressure and UmA were observed among three groups（P0.05）,however,there were no significant differences in the level of BUN,Ccr and K＋ among the three groups before and after the treatment（P0.05）.The level of UMA was significantly lowered in combined treatment group compared with those in Ramipril group and Telmisartan group（P0.05）.ConclusionThe therapy of Ramipril combined with Telmisartan is the feasible strategy for diabetic nephropathy.