缬沙坦联合阿托伐他汀治疗早期糖尿病肾病临床对照研究

The clinical efficacy of valsartan combined with atorvastatin on patients with diabetic nephropathy

目的 探讨缬沙坦联合阿托伐他汀治疗早期糖尿病肾病（Diabetic nephropathy,DN）的临床疗效及安全性.方法 本院收治的87例早期DN患者随机分为对照组45例和试验组42例.对照组给予缬沙坦80mg/d口服,试验组在对照组的基础上给予阿托伐他汀20mg/d口服.治疗16周后,比较两组患者血清肌酐（Scr）、血清丙二醛（MDA）、C反应蛋白（CRP）、尿蛋白排泄率（UAER）及肾小球滤过率（GFR）等各项临床指标情况及不良反应有无差别.结果 81例患者完成既定治疗方案并获随访,治疗后两组患者血清肌Ser、MDA、CRP及UAER较治疗前均明显下降（P＜0.05）；但试验组下降更为显著（P＜0.05）；治疗后两组患者GFR无明显变化（P＞0.05）；两组患者血清CRP下降水平与UAER下降水平呈正相关（rspearson=0.61,P＜0.05）.两组患者治疗期间不良反应发生率无明显差别（P＞0.05）.结论 缬沙坦联合阿托伐他汀治疗早期DN的临床疗效均优于单用缬沙坦,且联合应用不增加患者不良反应发生风险.

Objectives To evaluate the clinical efficacy and side effects of valsartan combined with atorvas tatin on patients with diabetic nephropathy. Methods 87 diabetic nephropathy patients admitted to our hospital were recruited and divided into control group（ n = 45 ） and treatment group（ n = 42） by randomized random number tablea. Patients in control group were given valsartan gorog/d. Patients in the treatment group were give valsartan 80mg/d plus atorvastatin 20mg/d. The serum Scr, MDA, CRF, UAER and GRF was compared between the two groups after 4 month treatment. Results 81 subjects completed the trim and follow up. The serum Scr, MDA, CRP and UAER were improve in both control and treatment groups（ P 〈0.05 ）. No statistical difference of side effect between the two goups was observed（ P 〈0.05）. Significant positive correlation between CRP decrease and UAER decrease was foundafter treatment（ rspearson = 0. 61, P 〈 0. 05 ）. Conclusions More clinical efficacy was found in the valsartan combined with atorvastatin regimen group compared to control group, without increase the side effects.