辛伐他汀与贝那普利单用或联用治疗糖尿病肾病

Simvastatin and benazepril used alone or in combination for treating diabetic nephropathy

目的:研究辛伐他汀、贝那普利联用或单用对糖尿病肾病的肾保护作用。方法:97例糖尿病肾病病人随机分为3组。辛伐他汀组34例,予辛伐他汀20mg,po,qd;贝那普利组31例,予贝那普利10mg,po,qd;联合用药组32例,予辛伐他汀与贝那普利口服,用法同前2组。疗程均为24wk,观察3组治疗前后的尿清蛋白排泄率(UAER)、内生肌酐清除率(Ccr)、血脂、血压等指标。结果:治疗后,3组UAER与尿蛋白均降低,血清蛋白升高(P<0.01)。联合用药组UAER降低(103±s47)mg·24h-1,降低幅度大于辛伐他汀组与贝那普利组[(35±29),(53±41)mg·24h-1,P<0.01],尿蛋白降低与血清蛋白增长幅度联合用药组大于其他2组(P<0.01,P<0.05)。3组Ccr与空腹血糖均下降,差异无显著意义(P>0.05)。3组血脂和血压降低均有所改善(P<0.01),联合用药组血脂改变程度优于其他2组(P<0.01,P<0.05)。结论:辛伐他汀与贝那普利联用治疗糖尿病肾病,对肾保护有协同作用。

AIM: To assess the renal protective effect of simvastatin and benazepril used al o ne or in combination for treating diabetic nephropathy. METHODS: Ninety-seven patients were randomly divided into three groups: 34 pati ents of simvastatin group were treated with simvastatin 20 mg, qd; 31 patients of benazepril group were treated with benazepril 10 mg, qd; 32 patients in comb in atin therapy group were treated with simvastation 20 mg, qd and benazepril (10 mg), qd. All patients in each group received the correlative therapy for 24 wk. The urinary albumine excretion rate (UAER), serum albumine (Alb), creatinine cleara nce (Ccr), serum creatinine (Scr), blood lipid and blood pressure were observed and recorded before and after the treatment. RESULTS: After the treatment, UAER, urine protein(UPT) decreased and the Alb increased in all three groups(P<0.01). But the UAER decreased (103±47) mg·(24 h^(-1)) in combination therapy group which was better than those in simvast atin group and benazepril group(((35±29)),(53±41) mg·24 h^(-1),P <0.01). Reduction of UPT and Alb in combination therapy group were more than those in t he other two groups(P<(0.01),P<0.05). The Ccr and fasting blood glu cose decreased in all groups with no significant difference among them ((P>0.0 5) ). The blood lipid and pressure were improved in all three groups ((P<0.0 1) ), especially in combination therapy group. CONCLUSION: Simvastatin and benazepril in combination therapy is superior to m on otherapy in the treatment of diabetic nephropathy.