缬沙坦联合依那普利治疗糖尿病肾病临床疗效观察

Clinical effects of valsartan and enalapril in the treatment of diabetic nephropathy

目的观察缬沙坦联合依那普利治疗糖尿病肾病(DN)的临床疗效。方法将2007年3月～2010年8月笔者所在科住院的126例2型糖尿病早期肾病患者随机分为三组,分别予以缬沙坦(缬沙坦组)、依那普利(依那普利组)以及依那普利和缬沙坦联合应用(联合组),治疗前后测定24 h尿蛋白定量(UAE)、血肌酐(SCr)、尿素氮(BUN)、血钾、血压等。结果三组治疗后血压均较治疗前有所下降,但差异无统计学意义(P>0.05);三组患者治疗12周后,SCr及BUN水平均有不同程度的下降,但差异无统计学意义(P>0.05),UAE水平明显下降,差异有统计学意义(P<0.05);而联合用药组治疗后UAE水平明显低于依那普利组和缬沙坦组(P<0.05)。三组均无严重不良反应。结论缬沙坦联合依那普利治疗糖尿病肾病患者疗效优于单一用药,且不良反应少。

Objective To observe the clinical effects of valsartan and enalapril in the treatment of diabetic nephropathy. Methods From Mar 2007 to Aug 2010, 126 patients of diabetic nephropathy were randomly divided into three groups： valsartan group, enalaprll group and united group. Urinary albumin, serum creatinine, blood urea nitrogen and blood pressure were measured before and after treatment. Results Blood pressure in three groups after treament were decreased, but the difference were no significant. The serum of SCr and BUN in three groups were desended, but the difference were no significant. The UAE were significantly decreased in three groups after treatment compared to those in before treatment （P 〈 0. 05 ）. Especialy, compared to the valsartan group and enalapril group, the UAE in united group was lower than them after treatment. There were no serious adverse effect happened. Conclusion Valsartan combined with enalapril in the treatment of DN was better than single medication, and it＇s little of adverse effect.