缬沙坦联合硝苯地平治疗早期糖尿病肾病合并高血压的疗效

Observation on the Efficacy of Valsartan Combined Nifedipine for the Treatment of Early Dia- betic Nephropathy with Hypertension

【目的】观察缬沙坦联合硝苯地平治疗早期糖尿病肾病（DN）合并高血压的临床疗效及安全性。【方法】选择符合纳入标准的90例早期DN合并高血压患者，随机分为观察组和对照组各45例；观察组给予缬沙坦联合硝苯地平治疗，对照组单用缬沙坦；治疗12周后观察两组患者收缩压（SBP）和舒张压（DBP）改善情况，评定降压疗效，并比较两组患者治疗前后的血尿素氮（BUN）、血肌酐（SCr）及尿白蛋白排泄率（UAER），记录用药过程中不良反应发生情况。【结果】观察组降压有效率为97．78％，优于对照组的82．22％（P〈0．05）；两组患者治疗后的SBP、DBP、BUN、SCr、UAER均较治疗前明显降低（P〈0．05），且观察组对SBP、DBP、BUN、UAER的改善优于对照组（P〈0．05）；两组不良反应发生率比较差异无统计学意义（P〉0．05）。【结论】缬沙坦联合硝苯地平临床治疗早期DN合并高血压安全有效，可明显降低患者的血压和蛋白尿，保护肾功能，值得应用。

[Objective]To observe the clinical efficacy and safety of valsartan combined nifedipine for the treatment of early diabetic nephropathy（DN） with hypertension. [MethodslTotally 90 cases of early DN patients with hypertension in accordance with the inclusion criteria were selected and randomly divided into observation group and control group with 45 cases in each. The observation group was treated with valsartan and nifedipine, while the control group was treated with valsartan. After 12 weeks of treatment, the improvement of systolic blood pressure（SBP） and diastolic blood pressure（DBP） in two groups were observed. The antihypertensive efficacy was evaluated. Blood urea nitrogen（BUN）, serum creatinine （SCr） and urinary albumin excretion rate（UAER） before and after treatment were compared. The adverse reactions in the course of medication were recorded. [Results]The effective rate in observation group was 97.78 %, which was better than that in control group（82.22%）（ P d0.05）. Compared with before treatment, SBP, DBP, BUN, SCr and UAER in two groups after treatment obviously deereased（ P 〈0.05）, and SBP, DBP, BUN, UAER of observation group were better than the control group（ P 〈0.05）. There was no significant difference in the incidence of adverse reactions between two groups（ P 〉0.05）. [Conelusion]Valsartan combined nifedipine for the treat- ment of early DN with hypertension is safe and effective, and can obviously reduce blood pressure and proteinuria, and protect renal function of patients. Therefore, it is worthy of clinical application.