氯沙坦钾和依那普利联合治疗Ⅳ期糖尿病肾病的临床观察

目的观察氯沙坦钾和依那普利联合治疗Ⅳ期糖尿病肾病（DN）的疗效。方法将74例Ⅳ期DN患者随机分为三组，氯沙坦钾组：151服氯沙坦钾100mg，1次／d；依那普利组；151服依那普利10mg，1次／d；联合治疗组：同时服用以上两种药物，且剂量不变。三组患者治疗均在3年以上。监测治疗前后24h尿蛋白定量及血清肌酐。结果三组患者24h尿蛋白定量较治疗前均下降，差异有统计学意义（P〈0．05），联合治疗组效果更好（P〈0．01）。血清肌酐仅联合治疗组下降，差异有统计学意义（P〈0．05）。结论联合应用氯沙坦钾和依那普利可以有效控制Ⅳ期DN患者蛋白尿，延缓肾脏病进展。

The clinical observation to the consociation treatment that losartan potassium combined with enalapril used in treating Ⅳ phase diabetic nephropathy

Objective To observe the curative effect that losartan potassium combined with enalapril used in treating Ⅳ phase diabetic nephropathy（DN）. Methods Divided 74 Ⅳ phase DN suffers into 3 groups randomly. Losartan group：taken losartan potassium tablets 100 mg once every day orally, enalapril group：taken enalapril tablets 10 mg once every day orally,consociation group：taken the two drugs above at one time with the same dosage. The treatment in the 3 groups were all above 3 years, monitoring the 24-hour albuminuria and SCr back and forth the treatment. Results It worthed statistics meaning that the 24-hour albuminuria in the 3 groups all declined （P 〈 0.05）. The effect of consociation group did better（P 〈 0.01 ）. In term of SCr,it declined in the consociation group worthed statistics meaning only. Conclusion The consociation application with losartan potassium and enalapril can control the proteinuria of Ⅳ phase DN sttffers efficiently as well as defer process of kidney diseases.