替米沙坦对高血压合并糖尿病患者早期肾损害的影响

目的探讨替米沙坦对高血压合并糖尿病患者血清胱抑素C(CystatinC,CysC)、微量白蛋白尿(Microalbuminuria,MAU)的影响。方法将80例原发高血压合并糖尿病伴早期肾损害患者按就诊顺序随机分为替米沙坦组40例和硝苯地平控释片组40例,均服药12周。观察两组用药前后血压、血肌酐、血钾、空腹血糖、血清胱抑素C(CysC)、尿白蛋白与肌酐比值(Urinary albumin to creatinine ratio,UACR)的变化。结果两组经12周治疗后血压均较治疗前明显降低(P<0.01),但两组治疗后血压比较,差异无统计学意义(P>0.05);两组治疗前后血肌酐、空腹血糖比较,差异无统计学意义(P>0.05);两组血清胱抑素C(CysC)、尿白蛋白与肌酐比值(UACR)均较治疗前降低(P<0.05),替米沙坦组优于硝苯地平控释片组(P<0.05)。结论替米沙坦可降低高血压合并糖尿病患者血清CysC及微量白蛋白尿水平,减轻肾脏损害,保护肾脏功能。

Effects of Telmisartan on Hypertension Patients with Diabetes Mellitus and Early Renal Damage

Objective To observe the effects of telmisartan on serum Cystatin C（CysC） and microalbuminuria（Microalbuminuria,MAU） of hypertension patients with diabetes mellitus and early renal damage.Methods 80 cases of primary hypertension patients with diabetes mellitus and early renal damage were divided into two groups according to visiting sequence：telmisartan group（n=40） and nifedipine group（n=40）.The telmisartan group was treated with telmisartan and the nifedipine group was treated with nifedipine.Both of groups were treated for 12 weeks.The changes of blood pressure,serum creatinine,serum potassium,fasting blood glucose,serum Cystatin C（CysC）,urinary albumin to creatinine ratio（UACR）before and after the treatment were measured.Results After 12 weeks of treatment,the blood pressure of the two groups were significantly lower than those before treatment（P〈0.01）,but there was no statistical difference in blood pressure between the two groups（P〈0.05）;There were no statistical differences between the groups with regard to serum creatinine and fasting blood glucose before and after the treatment（P〈0.05）;CysC and UACR of the groups were lower than those before treatment,but the efficacy of telmisartan group was better than that of the nifedipine group（P〈0.05）.Conclusion Telmisartan can reduce the levels of serum CysC and microalbuminuria of hypertension patients with diabetes mellitus,alleviate the damage of kidneys and protect renal functions.