贝那普利和缬沙坦联合治疗早期糖尿病肾病的临床观察

The observation of therapeutic efficacy of combination of benazepril and valsartan on the early stage diabetic nephropathy

目的:比较血管紧张素转换酶抑制剂(ACEI)贝那普利和血管紧张素受体阻滞剂(ARB)缬沙坦单用及联合治疗早期糖尿病肾病(DN)的疗效。方法:95例早期DN患者随机分为3组,给予贝那普利、缬沙坦或两者联合治疗12周。比较治疗前后血压、尿蛋白及血钾和血肌酐(Cr)等的变化。结果:上述两药均能有效降低早期DN的血压(P<0.01)和尿蛋白(P<0.05);联合治疗的降尿蛋白作用更明显(P<0.01),降压效果与单用组相似(P>0.05)。治疗前后的血钾、血Cr、尿素氮(BUN)无明显变化(P>0.05)。结论:对于早期DN患者,贝那普利和缬沙坦联合治疗与单用药相比具有更强的降尿蛋白作用,且这种作用是通过独立于血压的机制实现的。

OBJECTIVE To investigate the efficacy of monotherapy or combination of ACEI （benazepril） and ARB （valsar tan dispersible tablets） in treating the early stage diabetic nephropathy（DN）. METHODS 95 patients with early stage diabetic nephropa-thy（DN） were randomly allocated into there treatment groups： benazepril, valartan or the combination of these two drugs for 12 weeks. The changes of blood pressure, proteJnuria, serum potassium and ereadnine were observed before and after treatment. RESULTS Both of benazepril and valsartan reduced blood pressure（P〈0.01） and proteinuria（P〈0. 05） efficiently. And their effects were similar. In contrast, the reduction in proteinuria was greater in combination therapy than in treatments of either drug alone （P〈0. 01）, but their reductions in blood pressure were achieved to the same level （P〉0. 05）. There were no significant differences in serum levels of potassium, creatinine and BUN before and after treatment （P〉0. 05）. CONCLUSION A combination of benazepril and valartan in patients with the early stage DN produces a better anti-proteinuric effect than either of the monotherapies. This protection is not dependent on changes in blood pressure.