氯沙坦联合阿托伐他汀治疗糖尿病肾病的疗效观察

Therapeutic effects of the losartan combined with atorvastatin on the patients with diabetic nephropathy

目的探讨氯沙坦联合阿托伐他汀治疗糖尿病肾病（DN）的临床效果。方法将122例DN患者随机分为两组，对照组61例给予常规治疗加氯沙坦，观察组61例在对照组的基础上加用阿托伐他汀治疗，两组疗程均为12周，治疗12周后检测两组患者的收缩压（SBP）、舒张压（DBP）、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）、高密度脂蛋白胆固醇（HDL-C）、空腹血糖（FBG）、尿微量白蛋白排泄率（UAER）、血肌酐（Scr）、糖化血红蛋白（HbAIc）。结果观察组总有效率为93．44％，对照组为75．41％，两组相比较差异有统计学意义（X2=7．54，P〈0．01）；两组患者治疗12周后的SBP、DBP与治疗前比较均有所下降，差异有统计学意义（SBP：t=16．25，17．34，P〈0．01；DBP：t=18．10，17．04，P〈0．01）；对照组FBG、UAER、HbAlc均较治疗前明显降低（P〈0．05），观察组的TG、TC、LDL-C、HDL-C、FBG、UAER、Scr、HbAlc均较治疗前显著降低（P〈0．05），观察组的TG、TC、UAER、Scr明显低于对照组（P〈0．05）。结论氯沙坦联合阿托伐他汀治疗DN较常规治疗加氯沙坦在减少尿微量白蛋白作用方面更具优势，且能加强保护肾功能的作用。

Objective To investigate the therapeutic effects of the losartan combined with atorvastatin on patients with diabetic nephropathy （DN）. Methods 122 patients with DN were randomly divided into two groups, 61 cases in the control group were received conventional therapy and added the losartan, 61 cases in the observation group were treated by atorvastatin on the basis of the control group. The treatment time was 12weeks for each group. After 12 weeks, the systolic blood pressure （SBP）, diastolic blood pressure （DBP）, triglycerides （TG）, total cholesterol （TC）, low-density lipoprotein cholesterol （LDL-C）, high density lipoprotein cholesterol （HDL-C）, fasting blood glucose （FBG）, urinary albumin excretion rate （UAER） , serum creatinine （Scr） , and glycosylated hemoglobin （HbAIc） were measured. Reslflts The total effective rate was 93.44% in the observation group, and 75.41% in the control group, with a statistically significant difference between two groups （X2 =7. 54, P 〈0. 01 ）. After 12 weeks, the SBP and DBP were all changed more than before, DBP decreased more significantly （ SBP： t = 16. 25,17.34, P 〈 0. 01 ; DBP： t = 18.10,17.04, P 〈0. 01 ） ; FBG, UAER, and HbAlc in the control group were significantly reduced （ P 〈0.05） ; the TG, TC, LDL,-C HDL,-CFBG, UAER, Scr, and HbAlc of the observed group were significantly reduced more, too. TG, TC, UAER, and Scr of the observed group were significantly lower than the control group （ P 〈 0. 05）. Conclusions The losartan combined with atorvastatin that were used to treat patients with DN can reduce the urine albumin and protect the renal function.