西拉普利治疗老年糖尿病肾病的疗效观察

Effect of cilazapril on clinical therapy in elderly patients with diabetic nephropathy

目的:探讨西拉普利治疗老年糖尿病肾病(DN)的临床疗效。方法:61例老年DN患者随机分为2组,西拉普利组31例,每天口服2.5-5mg的西拉普利;络活喜组30例,每天口服5-10mg的络活喜;2组均用药6个月,于治疗前后测定2组的收缩压(SBP)、舒张压(DBP)、24h尿蛋白定量(24h-UP)及血清肌酐(SCr)、尿素氮(BUN)水平,并对2组进行比较。结果:(1)2组治疗后SBP、DBP均较治疗前明显下降(P均<0.05);2组组内治疗后SBP、DBP相比差异无统计学意义(P>0.05)。(2)西拉普利组治疗后24h-UP较治疗前明显下降(P<0.05),SCr、SUN水平虽有下降,但治疗前后差异无统计学意义(P>0.05);络活喜组治疗后SCr水平较治疗前明显升高(P<0.05),BUN、24h-UP无明显变化(P>0.05)。结论:西拉普利具有良好的降压和减少尿蛋白的作用,对DN患者的肾脏具有保护作用。

Objective： To observe the clinical treatment effect of cilazapril in elderly patients with diabetic nephropathy（DN）. Methods： Sixty-one cases elderly patients with DN were divided into two groups by random, with 31 cases in cilazapril group and 30 cases in amlodipine group. Cilazapril 2.5-5 mg/d or amlodipine 5-10 mg/d were taken respectively by the patients in the two groups for 6 months. The parameters of systolic blood pressure（SBP）, diastolic blood pressure（DBP）, serum creatinine（SCr）, blood urea nitrogen（BUN）, 24 h urinary protein （24h-UP） were measured and compared before and after treatment in both groups and between the two groups. Results： （1） Cilazapril and amlodipine could lower effectively blood pressure and there was statistical significance before and after treatment （P 〈0.05）. There was no statistical significance on antihypertensive effect between the two groups （P 〉0.05）. （2）Cilazapril group was supierior to amlodipine group on reducing 24h-UP and inhibiting the raise of SCr （P 〈 0.05） . Conclusion： Cilazapril has good effect on lowering high blood pressure and reducing 24h-UP, so it has remarkably protective effect on kidney of patients with DN.