联合用药治疗糖尿病肾病伴高血压的临床观察

目的 探讨联合用药对糖尿病肾病伴高血压患者的临床疗效.方法 将西安市第九医院2011年5月至2012年5月收治的50例糖尿病肾病伴高血压患者随机分为观察组和对照组,对照组（25例）给予依那普利10 ～20 mg/d,观察组在此基础上加用普伐他汀10 mg/d,治疗时间为3个月.观察并比较两组患者的临床疗效以及24 h尿蛋白定量、血压、总胆固醇、三酰甘油、肌酐等指标.结果 观察组总有效率为88.0%,对照组总有效率为72.0%,两组疗效比较差异有统计学意义（P＜0.05）;观察组治疗后TC、TG均较治疗前显著降低（P＜0.05）,且均显著低于对照组（P＜0.05）.24 h尿蛋白较治疗前降低（P＜0.05）,且观察组下降更为明显（P＜0.05）;舒张压和收缩压较治疗前均有显著下降（P＜0.05）.结论 联合用药可以起到保护肾功能和改善糖代谢的双重作用,效果满意,应在临床中推广应用.

The Clinical Observation of Combined Medication Treatment on Patients with Diabetic Nephropathy Complicating with Hypertension

Objective To explore the clinical effect of combined medication therapy on patients with diabetic nephropathy complicating with hypertension. Methods From May 2011 to May 2012,50 cases of patients with diabetic nephropathy complicating with hypertension admitted by Xi＇an Nioth Hospitalwere randomly divided into observation group and control group. The control group （25 cases） were given enal-april 10-20 mg/d,the observation group （25 cases） was added with pravastatin 10 mg/d on the basis of the control group treatment, both for 3 months, the cynical curative effect and indexes including 24 h urine protein quantity, bhx,d pressure, total cholesterol （ TC ）, triglyeride （ TG ）, creatinine （Cr） of the two groups were observed and compared. Results In the observation group total effective rate was 88% ,was 72% in the control group,anti the difference betweenthe two groups had statistical signifieanee（ P 〈 0.05 ） ; TC and TG levels after treatment in the observation group were signifieantly lower than before treatment （P 〈 0. 05 ）, and also significantly lower than in the control group （P 〈 0.05 ） ;24 h urine protein after treatment in both groups were significantly lower than before treatment（ P 〈 0.05 ）, and observation group decreased more significantly（ P 〈 0. 05 ） ;diastolic and systolic blood pressure were significantly decreased compared with those before treatment （ P 〈 0. 05 ）. Conclusion Combined medication has dual effects including renal function protection and glucose metabolism improvement, with satisfactory effect, which should be promoted in the clinical application.