缬沙坦联合贝那普利治疗糖尿病肾病的疗效观察

目的观察缬沙坦联合贝那普利治疗糖尿病肾病的疗效。方法将2011年1月～2012年1月于我院住院的2型糖尿病肾病患者80例随机分为贝那普利组（27例）、缬沙坦组（26例）、缬沙坦联合贝那普利组（联合组，27例），三组患者均连续给予控制血糖和血压治疗2周，在此基础上，三组分别采用贝那普利、缬沙坦、缬沙坦联合贝那普利治疗，均连续治疗12周。对所有患者的血压、空腹血糖（FPG）、血清电解质（K＋）、血尿素氮（BUN）及血肌酐（SCr）、肌酐清除率（Ccr）及24h尿蛋白进行观察，同时记录不良反应。结果三组治疗前后血压、24h尿蛋白治疗后与治疗前比较，差异均有统计学意义（P〈0．05），治疗后联合组与与贝那普利组、缬沙坦组比较，差异有统计学意义（P〈0．05）。三组治疗前后FPG、K＋、BUN、SCr、Ccr及不良反应的比较差异均无统计学意义（P〉0．05）。结论缬沙坦联合贝那普利治疗糖尿病肾病患者的血压、尿蛋白方面疗效较单一用药好，临床可安全应用。

Clinical observation of Valsartan combined with Benazepril in the treatment of diabetic nephropathy

Objective To observe the effect of Valsartan combined with Benazepril in the treatment of diabetic nephropathy.Methods 80 patients with diabetic nephropathy from January 2011 to January 2012 in our hospital were divided into three groups: Valsartan group(27 cases),Benazepril group(26 cases),Valsartan combined with Benazepril group(combined group,27 cases).Three groups of patients were continuously given to control blood sugar and blood pressure treatment for 2 weeks,on the basis,Valsartan,Benazepril and combined drugs were given the three groups,and the total time of the treatment was 12 weeks.And blood pressure,fasting plasma glucose(FPG),serum electrolytes(K+),blood urea nitrogen(BUN) and serum creatinine(SCr),creatinine clearance rate(Ccr) and 24 h urinary protein for all patients were observed,and the adverse reactions were recorded.Results Before and after treatment in three groups,blood pressure,24 h urinary protein after treatment were compared,there were significant differences(P < 0.05),the combined group compared with the Benazepril group and Valsartan group,there were significant differences(P < 0.05).FPG,K+,BUN,and SCr and Ccr and adverse reactions in the three groups before and after treatment showed no significant differences(P > 0.05).Conclusion Valsartan combined with Benazepril in the treatment of diabetic nephropathy has good efficacy in blood pressure,urinary protein and is better than the single drug,and can be used safely in clinic.