阿伐他汀联合贝那普利治疗早期糖尿病肾病临床观察

Clinical Observe Effect of Atorvastatin Combined with Benazepril Treatment of Early Diabetic Nephropathy

目的:观察阿伐他汀联合贝那普利治疗早期糖尿病肾病的疗效并探讨其可能机制。方法:选取糖尿病肾病患者78例,随机分为对照组和治疗组,对照组在常规饮食和降糖药物治疗的基础上加贝那普利(10mg1/d),治疗组在对照组基础上使用阿伐他汀(20mg1/晚),疗程6个月。观察治疗前后患者血压、血脂、尿白蛋白排泄率、肾功能和C-反应蛋白变化。结果:两组治疗后收缩压、舒张压和平均动脉压(MAP)较治疗前显著下降,差异有统计学意义(P<0.01),治疗组治疗后血胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)和C-反应蛋白(CRP)显著下降(P<0.01),与对照组治疗后比较差异有统计学意义(P<0.01),两组治疗后血肌酐水平均较治疗前下降(P<0.05);治疗组治疗后尿蛋白排泄率下降显著(P<0.01),明显优于对照组(P<0.01)。结论:阿伐他汀联合贝那普利在降低血压和血脂的同时能有效的降低尿蛋白排泄率、抑制慢性炎症、改善肾功能,明显延缓糖尿病肾病进展。

Objective ：To observe atorvastatin combined with benazepril treatment of early diabetic nephropathy （DN） and investigate the possible mechanisms. Methods ：78 patients of DN were randomly assigned to the control group and the treatment group. The control group, on the basis of the conventional diet and hypoglycemic treatment plused benazepril （10mg qd）treat. Treatment group treated by atorvastatin（20mg qn）on the basis of control group, with a treatment couse of 6 months for both group. We observed the change of blood pressure, blood lipids, urinary albumin excretion rate, renal function and C - reactive protein afte treatment. Re- suits：After treatment in the two groups, systolic blood pressure, diastolic blood pressure and mean arterial pressure（MAP） was signifi- cantly lower than before treatment and the difference was statistically significant（P 〈0.01 ）. After treatment in the treatment group, blood cholesterol （ TC）, triglyceride （ TG）, low - density lipoprotein cholesterol （ LDL - C ） and C - reactive protein （CRP） was signifi- cantly decreased（P 〈 0.01 ）. Compared with the control group, the difference was statistically significant（P 〈 0.01 ）. After treatment in the two groups, serum creatinine level decreased than before（P 〈 0.05）. After treatment in the treatment, urinary albumin excre- tion rate decreased significantly （P 〈 0.01 ）, significantly better than the control group （P 〈 0.01 ）. Conclusion： Atorvastatin combined with benazeprilr treatment can reduce blood pressure and lipids and effectively reduce urinary protein excretion rate, inhibition of chro- nic inflammation, improve kidney function significantly , slow the progress of diabetic nephropathy.