联合用药对高血压合并2型糖尿病患者早期肾脏保护效果的研究

目的探讨联合用药对高血压合并2型糖尿病患者的早期肾脏保护效果。方法将120例高血压合并2型糖尿病患者按照随机数字表法分为观察组与对照组各60例，观察组采用厄贝沙坦联合氢氯噻嗪治疗，对照组采用依那普利联合氢氯噻嗪治疗。对两组患者进行动态血压监测，比较两组患者的治疗效果和肾脏保护效果。结果治疗4周后，观察组舒张压和收缩压下降程度均高于对照组，差异有统计学意义（P〈0．05）；患者24h、白昼及夜间的收缩压和舒张压均低于治疗前，差异均有统计学意义（P〈0．05）；观察组血尿素氮水平低于对照组，差异有统计学意义（P〈0．05）。结论厄贝沙坦联合氢氯噻嗪治疗高血压效果较好，降压持久稳定，对患者的肾脏损害轻，可以在临床中推广。

Study of early protective effect to kidney of combination regimens in the treatment of hypertension in type 2 diabetic patients

Objective To explore the effect of combination regimens in the treatment of hypertension in type 2 diabetic patients with early kidney. Methods 120 cases of hypertensive patients with type 2 diabetes mel- litus were divided into observation group and control group with 60 cases in each group, the observation group was treated with irbesartan and hydrocldorothiazide treatment, the control group using enalapril plus hydrochlorothiazide treatment. And ambulatory blood pressure monitoring was performed on two groups of patients, therapeutic effect of two groups were compared and the renal protective effect. Results In observation group, diastolic and systolic blood pressure decreased significantly than that in the control group, the difference was statistically significant （P〈 0.05 ）, after 4 weeks of treatment in patients with 24 h, daytime and nighttime systolic and diastolic blood pres- sure were lower than those before treatment, the differences were statistically significant （P〈0.05）, in observation group, blood urea nitrogen was lower than the control group, the differences were statistically significant（P〈0.05）. Conclusion Irbesartan combined with hydrochlorothiazide in the treatment of hypertension is better blood pressure stable, on renal damage in patients with light, can be used in the clinical treatment.