硝苯地平控释片联合缬沙坦治疗老年2型糖尿病肾病合并高血压的临床观察

Clinical Efficacy of Nifedipine Controlled Release Tablet and Valsartan in the Treatment of Type 2 Diabetic Nephropathy and Hypertension of Elderly Patients

目的观察硝苯地平控释片联合缬沙坦治疗老年2型糖尿病肾病(DN)合并高血压的临床疗效及安全性。方法将62例老年2型DN合并高血压患者随机分为硝苯地平控释片组(20例)、缬沙坦组(20例)及联合治疗组(22例)。3组患者均口服降糖药或皮下注射胰岛素,血糖达标后口服降压药物治疗。硝苯地平控释片组、缬沙坦组患者分别给予硝苯地平控释片30 mg、缬沙坦80 mg,1次/d;联合治疗组给予硝苯地平控释片30 mg+缬沙坦80 mg,1次/d。疗程为6个月。观察治疗前后3组患者血压、24 h尿微量清蛋白排泄率(UAER)和肾功能变化。结果治疗后联合治疗组患者血压及24 h UAER均显著低于硝苯地平控释片组和缬沙坦组,差异有统计学意义(P均<0.05);治疗过程中3组均未见明显不良反应。结论硝苯地平控释片联合缬沙坦治疗老年2型DN合并高血压效果优于单独用药,且较为安全。

Objective To observe the clinical efficacy and safety of nifedipine controlled release tablets（NCRT） and valsartan in the treatment of type 2 diabetic nephropathy（DN） and hypertension in elderly patients.Methods 62 elderly patients with type 2 DN and hypertension were randomly divided into NCRT group（20 cases）,valsartan group（20 cases） and combined treatment group（22 cases）.The three groups were all given hypoglycemic drug per os or subcutaneous injection of insulin,and they were given antihypertensive drugs after blood glucose reached target level.Patients in NCRT group and valsartan group were given 30 mg NCRT and 80 mg valsartan once a day,while patients in combined treatment group were given 30 mg NCRT and 80 mg valsartan once a day.The course of treatment was six months.The blood pressure,24 h UAER and changes of renal function of the three groups were observed before and after treatment.Results After treatment,the blood pressure and 24 h UAER of combined treatment group were significantly lower than those of the NCRT group and valsartan group（P〈0.05）.No adverse reactions were found during treatment.Conclusion The combination of NCRT and valsartan in the treatment of type 2 DN and hypertension in elderly patients shows efficacy superior to single drug with satisfactory safety.