福辛普利单用及其与辛伐他汀联用治疗糖尿病肾病的临床观察

Clinical observation of fosinopril used alone and combination with simvastatin in the treatment of patients with diabetic nephropathy

目的研究福辛普利单用及与辛伐他汀联用对糖尿病肾病患者的肾脏保护作用。方法将60例糖尿病肾病患者随机分为两组。福辛普利组30例，给予福辛普利10mg，口服，1次／d；联合用药组30例，给予辛伐他汀与福辛普利，辛伐他汀20mg，口服，1次/d，福辛普利用法同前组。疗程均为24周，观察两组治疗前后的尿白蛋白排泄率（UAER）、内生肌酐清除率（Ccr）、血脂、血压等指标。结果治疗后两组UAER与尿蛋白均降低，血清白蛋白升高（P〈0．01）。联合用药组UAER降低，降低幅度大于福辛普利组（P〈0．01），尿蛋白降低与血清蛋白增长幅度联合用药组大于福辛普利组（P〈0．01）。两组Ccr与空腹血糖均下降，差异无统计学意义（P〉0．05）。两组血脂和血压降低均有所改善（P〈0．01），联合用药组血脂改变程度优于福辛普利组（P〈0．01）。结论福辛普利与辛伐他汀联用治疗糖尿病肾病，对肾脏保护有协同作用。

Objective To investigate the renal protective effects of fosinopril used alone and com- bination with simvastatin on patients with diabetic nephropathy. Methods Sixty patients with diabetic ne- phropating were randomly divided into two groups ：30 patients in fosinopril group were treated with fosino- pril 10 mg, po, qd ; 30 patients in combination therapy group were treated with simvastation 20 rag, po, qd and fosinopril 10 mg, po, qd. The course of treatment was 24 weeks. The urinary albumin excretion rate （ UAER）, serum albumin （Alb）, creatinine clearance （Ccr）, serum creatinine （Scr）, blood lipid and blood pressure were observed and recorded before and after the treatment. Results After the treatment, UAER, urine protein （UI^F） decreased and the Alb increased in the two groups （P 〈 0. 01 ）. But the UAER decreased in combination therapy group was better than that in fosinopril group group （P 〈 0. 01 ）. Reduction of UPT and the Alb increased in combination therapy group were more than those in the fosino- pril group （P 〈 0. 01 ）. The Ccr and fasting blood glucose decreased in all groups, there was no significant difference between them （ P 〉 0. 05）. The blood lipid and pressure improved in two groups （ P 〈 0. 01 ）, especially in combination therapy group. Conclusions The combination treatment of simvastatin and fosinopril has synergestic effect on renal function protection in the treatment of diabetic nephropathy.