不同剂量联合应用缬沙坦与辛伐他汀治疗糖尿病肾病疗效观察

Evaluation on the therapeutic effect of treating diabetic hephropathy (DN) using varied dosage of simvastatin combined with Valsartan

目的观察不同剂量联合应用缬沙坦与辛伐他汀治疗糖尿病肾病(DN)的临床疗效。方法选择DN60例,随机分为治疗组与对照组,两组患者均接受一般治疗,包括使用降糖药及缬沙坦,对照组缬沙坦剂量为80mg1日1次另予辛伐他汀20mg每晚口服。治疗组缬沙坦剂量为160mg1日1次另予辛伐他汀40mg每晚口服,共60天治疗前后分别测尿素氯(BUN)、肌酐(Cr)、24h尿蛋白排泄率(UAER)和尿β2微球蛋白(Uβ2-MG)。结果两组BUN、Cr、UAER和Uβ2-MG治疗前后比较有显著性差异(P<0.01),治疗组治疗后UAER与对照组治疗后比较有统计学意义(P<0.05)。结论缬沙坦与辛伐他汀大剂量联合治疗DN,可减少尿蛋白,改善肾功能,且两药大剂量联用较常规剂量联用可更有效地控制与延缓DN病情的进展。

OBJECTIVE To observe the therapeutic effect of treating diabetic hephropathy（DN）using varied dosage of simvastatin combined with varied dosage of Valsartan.METHODS 60 Patients of DN were randomly divided into two groups,treating group（AB）and control group（A）,Hypoglycemic agent and Valsantan were given to both groups,Valsartan 80mg po qd in control group,Simvastatin 20mg Po Qn were added in it,While in treating group Valsartan 160mg po qd and Simvastatin 40mg po qn.The course of treatment lasted for 60 days.UAER,BUN,Cr,Uβ2-MG were tested before and after treatment.RESULTS In both groups there were all significient differences in BUN Cr、UAER Uβ2-MG before and after treatment（P0.01）and there was significient difference in the decrease of UAER between the two groups（P0.05）.CONCLUSION Treating diabetic nephropathy using high-dosed simvastatin combined with high-dosed Valsartan has a better effect in reducing the urine protein and improving renal function than using normal-dosed valsartan.combined with normal-dosed Valsartan