氯沙坦治疗糖尿病肾病的疗效观察

Effects of losartan on Patients with type 2 diabetic nephropathy

目的 :观察氯沙坦对糖尿病肾病蛋白尿和肾功能的影响。方法 :将 46例糖尿病肾病病人分为A和B两组。A组 2 6例 ,Scr正常 ,2 4h尿蛋白≥ 0 .5 g ,分为A1和A2 组各 13例。B组 2 0例 ,Scr在 110～ 35 4μmol/L ,分为B1和B2 各 10例。A1和B1组给予氯沙坦 5 0～ 10 0mg/d ,A2 和B2 组给予洛汀新 10～ 2 0mg/d。观察治疗 3个月前后血压、2 4h尿蛋白、Scr和BUN变化。结果 :氯沙坦和洛汀新均可有效降低血压、减少尿蛋白、降低Scr和BUN水平。且氯沙坦无干咳副作用 ,较洛汀新更少发生高钾血症以及Scr进一步升高。结论 :氯沙坦可有效降低血压、减少蛋白尿、降低Scr和BUN水平 ,阻止或延缓糖尿病肾病的发展 ,且副作用小 ,耐受性好。

Objective: To observe the effects of Losartan on patients with diabetic nephropathy.Methods :46 patients with diabetic nephropathy were divided into A and B groups randomly. A group,consisting of 26 patients with protein urine(≥0.5 g/24 h)and normal level of creatinine (Scr),divided into A 1 and A 2 ;B group included 20 patients with level of serum creatinine from 110 to 354μmol/L,divded into B 1 and B 2 groups.patients in A 1 and B 1 group were treated with losartan 50～100 mg everyday,and patients in A 2 and B 2 group were received lotensin 10-20 mg everyday.Changes of blood pressure and Scr and BUN were observed before and after 3 months therapy.Results: Losartan and lotensin had significantly lowered blood pressure, decreased protein urine and Scr and BUN in patients with diabetic nephropathy.There were not significant different in patients treated by losartan and lotensin.Conclusion: Losartan can slow or inhibt progression of diabetic nephropathy through lowering blood pressure and decreasing protein urine in patients with diabetic nephropathy.