氯沙坦联合通心络对2型糖尿病患者肾功能的影响

目的探讨通心络联合氯沙坦对糖尿病患者肾功能的影响。方法100例2型糖尿病患者随机分成两组,每组50例。氯沙坦组(A组):氯沙坦50mg,每日晨1次口服;氯沙坦联用通心络组(B组):氯沙坦50mg,每日晨1次口服;通心络胶囊3粒,每日3次口服。疗程均为24周。治疗前、后观察血压、血糖及肾功能指标变化。结果(1)A组和B组均有明显的降压作用(P<0.01),B组降压作用较A组显著(P<0.01);(2)尿蛋白排泄量:Alb(mg/24h)分别由106±10、107±10降至88±9、70±9(P<0.01);24h尿蛋白(g/L)分别由0.250±0.063、0.250±0.083降至0.213±0.043、0.170±0.025(P<0.01);2组血、尿β2-微球蛋白(β2-MG)较治疗前均有显著性降低(P<0.01),B组较A组更具显著意义(P<0.01)。(3)BUN、Cr治疗前、后比较无显著差异(P>0.05);(4)2组治疗后血糖水平均降低(P<0.01)。结论氯沙坦联合通心络具有明显降血压、稳定血糖的作用;明显降低尿蛋白的排泄,保护肾功能。

Effect of Tongxinluo combined with losartan on renal function in patients with type 2 diabetic mellitus

Objective To investigate the effect of Tongxinluo combined with losartan on renal function in patients with type 2 diabetic mellitus.Methods 100 patients with diabetic mellitus were randomly divided into two groups.group A:losartan (50 mg qd,n=50);group B:Tongxinluo combined with losartan (losartan 50mg qd, Tongxinluo 3 capsules once,3 time a day,n=50),with a treatment course of 24 weeks. Parameters including blood pressure,blood sugar and renal function were measured before and after treatment.Results ①After treatment,the blood pressure in group A and group B was significantly decreased (P<0.01).The levels of blood pressure in group B were significantly lower than that of group A (P<0.01);②Urinary albumin excretion (mg/24 h):106±10,107±10 vs 88±9,70±9 respectively (P<0.01).24 h urine protein (g/L) was 0.250±0.063,0.250±0.083 vs 0.213±0.043,0.170±0.025 respectively (P<0.01).The levels of blood and urine β2-MG were also significantly decreased in both groups (P<0.01).There was a significantly difference between two groups (P<0.01).③After treatment of blood ureanitrogen (BUN) and blood creatmine (Cr) were not significantly changed,compared with those before treatment in the two groups (P>0.05).④After treatment, losartan or Tongxinluo combined with losartan,the levels of blood sugar in group B were obviously lower than those in group A (P<0.01).Conclusion Losartan combined with Tongxinluo could significantly decrease the levels of blood pressure and blood sugar in patients with diabetic mellitus, which could decrease urinary albumin excretion and protect renal function.