贝那普利联用罗格列酮治疗早期糖尿病肾病

Benazepril Combined with Rosiglitazone in Patients with Earlier Period Diabetic Nephropathy

目的观察贝那普利联用罗格列酮治疗早期糖尿病肾病(DN)的临床效果。方法将本科64例早期DN患者随机分为联合用药组(34例)和贝那普利单用组(30例)。贝那普利单用组患者予以一般治疗、胰岛素治疗及口服贝那普利。联合用药组联用罗格列酮4 mg/天,共3个月。治疗前后分别测收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)、血肌酐(Scr)、尿素氮(BUN)、超敏C反应蛋白(us-CRP)、空腹血糖(FBG)、24 h尿蛋白量(Upr)、尿β2-MG。结果两组患者治疗后FBG、SBP、DBP、TC、TG、LDLC、尿β2-MG与治疗前比较下降显著(P<0.05);联合用药组;中Upr、us-CRP、Scr在治疗后也均有显著下降(P<0.05)。联合用药组;FBG、us-CRP、Scr、Upr、尿β2-MG改善优于对照组(P<0.05)。结论贝那普利联用罗格列酮治疗DN在减少尿蛋白、改善肾功能方面明显优于单用贝那普利,提示两药联用在延缓DN进展可能有协同作用。

Objective To evaluate the clinical efficacy of benazepril combined with rosiglitazone in patients with earlier period diabetic nephropathy （ DN ）. Methods 64 patients with earlier period DN were randomly allocated to a therapeutic group （ n = 34 ）or a control group （ n = 30 ）. Patients in the two groups were given the same regimen, such as common treatment, insulin injection and oral benazepril. The therapeutic group were added with oral rosiglitazone 4 mg daily for 3 months. Before and after treatment, levels of systolic blood pressure （ SBP ）, diastolic pressure （ DBP ）, total cholesterol （ TC ）, triglyeeride （ TG ）, high - density lipoprotein cholesterol （ HDLC ）, low - density lipoprotein holesterol （ LDL - C ）, creatinine （ Scr ）, urea nitrogen （ BUN ）, high - sensitivity C - reactive protein （ us - CRP ） , fasting blood glucose （ FBG ）, 24 h urine protein（Upr） , urine beta2 - MG were detected respectively. Results In both groups, statistically significant differences in levels of FBG, SBP, DBP,TC ,TG, LDLC, urine beta2 -MG were observed before and after treatment （ P 〈 0.05 ）. In the treatment group, as compared with the bacia lever, us - CRP, Scr, Upr were decreased （ P 〈 0.05 ） , in the control group,they were decreased,but have no statistically differences; FBG, us -CRP, Scr, Upr, urine β2 -MG were recorded in the therapeutic group as compared with controls （ P 〈 0.05 ）. Conclusion Benazepril combined with rosiglitazone in treatment of DN showed better effectiveness in reducing albuminuria and improving renal function than benazepril alone,which suggested that combination of the two drugs can be synergistic against DN development.