卡维地洛联合胰激肽原酶注射液治疗2型糖尿病肾病合并高血压患者临床疗效和安全性

【目的】探讨卡维地洛联合胰激肽原酶注射液治疗2型糖尿病肾病合并高血压患者的疗效和安全性。【方法】94例2型糖尿病肾病合并高血压的患者随机分为两组,各47例。所有患者均接受常规治疗,在此基础上,对照组予以卡维地洛治疗,观察组予以卡维地洛联合胰激肽原酶注射液治疗,连续治疗3个月。观察两组治疗前后的血糖、血压、贤功能、肾动脉血流动力学指标以及临床疗效和不良反应发生率。【结果】(1)观察组治疗总有效率明显高于于对照组(78.72%vs 59.57%,P<0.05)。(2)治疗后两组患者的血糖、血压较治疗前均有所降低(P<0.05),治疗后两组患者空腹血糖(FPG)、餐后2 h血糖(2hPG)、收缩压(SBP)、舒张压(DBP)比较差异均无显著性(P>0.05)。(3)治疗后两组血清尿素氮(BUN)、肌酐(SCr)、肾小球滤过率(GFR)、24 h尿微量白蛋白排泄率(UAER)、尿微量白蛋白(UAlb)均有所降低,且观察组降低幅度大于对照组(P<0.05)。(4)治疗后两组阻力指数(R I)明显下降,肾段动脉收缩期血流峰值速度(Vmax)、舒张末期血流速度(Vmin)明显上升,且观察组各指标变化幅度均大于对照组(P<0.05)。(5)两组患者治疗期间不良反应发生率相比较差异无显著性(P>0.05)。【结论】卡维地洛联合胰激肽原酶注射液治疗2型糖尿病贤病合并高血压患者疗效确切,可显著降低血糖、血压水平,改善双肾血流动力学及肾功能,且安全有效。

Clinical Efficacy and Safety of Carvedilol Combined with Pancreatopeptidase Injection in the Treatment of Type 2 Diabetic Nephropathy Complicated with Hypertension

【Objective】To investigate the clinical efficacy and safety of carvedilol combined with pancreatopeptidase injection in the treatment of type 2 diabetic nephropathy with hypertension.【Mdthods】A total of 94 patients with type 2 diabetic nephropathy complicated with hypertension were randomly divided into two groups,with 47 eases in each group.All patients received routine treatment.On this basis,the control group was treated with carvedilol,and the observation group was treated with carvedilol combined with pancreatopeptidase injection for 3 months.Blood glucose,blood pressuret renal function,renal artery hemodynamics,clinical efficacy and adverse reactions were observed before and after treatment in two groups.【Results】(1)The total effective rate of treatment in the observation group was significantly higher than that in the control group(78.72%vs 59.57%,P<0.05).(2)The blood pressure and glucose of the two groups after treatment were lower than those before treatment(P<0.05).There were no significant differences in FPG,2hPG,SBP and DBP between the two groups before and after treatment(P>0.05).(3)After treatment,BUN,SCr,GFR,UAER and UAlb decreased in both groups,and the extent of decrease in the observation group was greater than that in the control group(P<0.05).(4)After treatment,RI of the two groups decreased significantly,the peak velocity of renal artery systolic velocity(Vmax)and the end diastolic velocity of renal artery(Vmin)increased significantly;and these increase in the observation group were larger than that those in the control group(P<0.05).(5)There was no significant difference in the incidence of adverse reactions between the two groups(P〈0.05).【Condusion】Carvedilol combined with pancreatopeptidase injection is more effective in the treatment of type 2 diabetic nephropathy complicated with hypertension.It can significantly reduce blood glucose and blood pressure,improve the renal function and hemodynamics of both kidneys,and is safe and effective.