缬沙坦联合氨氯地平治疗早期糖尿病肾病合并高血压疗效观察

Therapeutic effect of levamlodipilne and valsartan in the treatment of diabetic nephropathy associated hypertension

目的研究血管紧张素Ⅱ受体阻滞剂(缬沙坦)单独和联合苯磺酸氨氯地平应用对Ⅱ型糖尿病肾病(DN)合并高血压患者降压疗效及其对尿蛋白排泄量的影响。方法 122例DN合并高血压患者随机分为2组,缬沙坦组(对照组)60例,给予缬沙坦80 mg,1次/d;观察组62例,给予左旋氨氯地平5mg及缬沙坦80 mg,1次/d。疗程均为12周。治疗后观察降压效果及尿蛋白排泄量的变化。结果 2组治疗后均能显著降低血压、空腹血糖、糖化血红蛋白,降低血尿素氮、肌酐及尿蛋白排泄量,但观察组降低血压及尿蛋白排泄量的幅度明显高于对照组(P<0.01)。结论缬沙坦单独和联合氨氯地平治疗DN合并高血压,均可明显降低血压,减少血尿素氮、肌酐及尿蛋白排泄量,保护肾功能,但与苯磺酸氨氯地平两药联用时降压作用及改善蛋白尿作用更好。

Objective To study the therapeutic effects of angiotonin II blocker （valsartan） alone and levamlodipin combined treatment in diabetic nephrosis patients with hypertension and their influence on hypertension and atbuminuria. Methods A total of 122 patients with type 2 diabetic nephrosis complicated with hypertension were divided into two groups. The control group （n --60） received valsartan 80 mg once a day, and the observation group （combined treatment group, n = 62） received levamiodipine 5 mg plus valsartan 80 mg once a day. The treatment course of two 2 groups was 12 weeks. The antihypertensive effect and the change of albuninuria were observed after treatment. Results After treatment, all of the 2 groups showed significant lowering of blood pressure, fasting glucose and glycosylated hemoglobin, decreasing of urea nitrogen, creatinine, uri- nary albumin and urinary protein excretion rate per 24 hours. The decreasing extent in blood pres- sure and albuminuria was more pronounced in the observation group （P 〈 0.01 ）. Conclusion The long-term treatment of valsartan alone for diabetic nephropathy with hypertension patients can lower the blood pressure and decrease urinary albumin and urinary prorein excretion volume, protect the renal function, but combined use of levamlodipine would give better effect in lowering blood pressure and protecting urine founction.