缬沙坦联合贝那普利对慢性肾小球肾炎蛋白尿降低和肾功能保护作用的临床研究

目的:观察血管紧张素转化酶抑制剂(ACEI)联合血管紧张素受体拮抗剂(ARB)治疗慢性肾小球肾炎的疗效。方法:将65例慢性肾小球肾炎患者随机分为三组:ACEI组、ARB组和联合组。ACEI组应用贝那普利,ARB组应用缬沙坦,联合组联合应用贝那普利及缬沙坦。观察治疗后3,6,9个月的相关指标变化。结果:经过9个月治疗后,三组患者24 h尿蛋白及血压显著下降(P<0.05);肾功能及血钾无明显变化(P>0.05);不良反应小。三组中联合组有最强的减少尿蛋白和降低舒张压作用(P<0.05),而在改善肾功能、血钾波动及不良反应方面,三组间差异无统计学意义(P>0.05)。结论:联合药物治疗慢性肾小球肾炎有更强的降低蛋白尿和舒张压的作用。

The clinical observation of the effect of valsrtan and benazepril on the proteinuria and renal function in chronic glomerulonephritis

Objective：To investigate the effect of angiotensin - converting enzyme inhibitor（ACEI）combining with angiotensin receptor blocker（ARB）on chronic glomerulonephritis. Methods：A randomized control trial was carried out in sixty - five chronic glomerulonephritis patients,who were divided into ACEI group,ARB group and combined group. The ACEI group received lotensin,and the ARB group received valsartan,while the combined group received therapy of lotensin and valsartan. Clinical data were collected in the beginning,3rd month,6th month,9th month. Results：Proteinuria of 24 h and blood pressure were significantly decreased after 9 month therapy in all groups patients（P ﹤ 0. 05）,while the GFR and the level of serum potassium in these patients remained the same after statistical analysis（P ﹥ 0. 05）. Combined therapy had the most noticeable antiproteinuric and blood pressure lowering effect,while renal function improvement,the level of serum potassium and the manifestations of side effects in combined group were similar to those in other two groups（P ﹥ 0. 05）. Conclusion：ACEI combining with ARB has better anfiproteinufic and blood pressure lowering effect.