替米沙坦联合辛伐他汀治疗糖尿病肾病疗效观察

Clinical effect of telmisartan combined with simvastatin in treatment of early diabetic nephropathy

目的探讨替米沙坦与辛伐他汀联用对早期糖尿病肾病的保护作用。方法将46例合并早期肾病的2型糖尿病患者随机分为替米沙坦与辛伐他汀联合治疗组（n=23）和对照组（n=23）。对照组采用正规胰岛素治疗，卡托普利为10mg／次，3次／d；治疗组在对照组的治疗基础之上加用替米沙坦80mg／次，辛伐他汀20mg／次，均1次／d。两组疗程均为16周。连续治疗16周后测血压、微量白蛋白尿（MAU）、TC、HDL-c及LDL-C。观察两组治疗前后各项指标的变化。结果治疗16周后，治疗组及对照组患者尿MAU水平均较治疗前显著下降（均P〈0．01），但治疗组较对照组下降明显（P〈0．01）。治疗组血脂改变程度优于对照组（P〈0．01）。两组治疗前后及同期各组间肾功能、空腹血糖水平、HbA1c变化均无统计学意义。结论替米沙坦与辛伐他汀联用较传统单用ACEI抑制剂治疗更有利于延缓糖尿病早期。肾病的发展。

Objective To evaluate the clinical efficacy and salty of combined treatment telmisartan plus simvastatin on early diabetic nephropathy. Methods 46 patients with early diabetic nephropathy were randomly divided into two groups. Control group （n = 23 ） received regular insulin therapy, captopril 10rag tid. Study group received telmisartan 80mg qd plus simvastatin 20mg qd on the basis of control group therapy. All patients received 16 weeks treatment. The clinical parameters were measured before and after therapy. Results After 16 weeks treatment,the u- rine ,AU in both study group and control group were significantly decreased（ all P 〈0.01 ） ,however,the urine MAU in telmisartan plus simvastatin combination group decreased significantly than control group（ P 〈 0.01 ）. Improvement of lipid level in the study group better than the control group（ P 〈 0.01 ）. Kidney function ,fasting blood glucose levels and HbA.le had no significant changes before and after treatment. Conclusion Telmisartan plus simvastatin combined treatment was better than the traditional therapy,which can delay the development of early diabetic nephropathy.