氯沙坦加苯那普利治疗糖尿病肾病疗效观察

Combined losartan and lotensin in the treatment of diabetic nephropathy

目的 :观察氯沙坦加苯那普利治疗糖尿病肾病的疗效。方法 :将 5 4例糖尿病肾病病人分为A和B两组。A组 3 0例 ,Scr正常 ,2 4h尿蛋白≥ 0 .5g ,分为A1、、A2 和A3组各 10例。B组 2 4例 ,Scr在 110～ 3 5 4 μmol/L ,分为B1、B2 和B3各 8例。A1和B1组给予氯沙坦 5 0mg和苯那普利 10mg ,A2 和B2 组给予氯沙坦 5 0～ 10 0mg ,A3和B3组给予苯那普利 10～ 2 0mg。观察治疗 3个月前后血压、2 4h尿蛋白、Scr和BUN变化。 结果 :单独用氯沙坦或苯那普利和联合用药可明显降低血压、减少尿蛋白、降低Scr和BUN水平 (P≤ 0 .0 5orP <0 .0 1)。尽管各组间对比无显著性差异 ,但就降低血压、减少尿蛋白、降低Scr和BUN的幅度以联合用药组最明显。结论 :氯沙坦和苯那普利治疗糖尿病肾病 ,较单独应用这两种药物能更有效地降低血压、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。

Objective: To observethe effects of combined losartan and lotensin in the treatment of diabetic nephropathy. Methods: 54 patients with diabetic nephropathy were divided into groups A and B. group A,consisting of 30 patients with proteinuria (≥0.5g/24h) and normal serum creatinine (Scr) was subdivided into groups A 1 ,A 2 and A 3. Group B included 24 patients with Scr ranging from 110 to 354μmol/L was subdivided into Group B 1 ,B 2 and B 3. Patients in A 1 and B 1 were treated with losartan 50mg and lotensin 10mg everyday, A 2 and B 2 were treated with losartan 50～100mg everyday, and A 3 and B 3 received lotensin 10～20mg everyday. MABP, Scr , BUN and 24h urine protein excretion were observed before and 3 months after therapy. Results: Losartan or lotensin alone or in combination significantly lowered MABP, 24h urine protein excretion and Scr and BUN in patients with diabetic nephropathy(P<0.05 or P<0.01). Although there were not significant differences among groups, reduction of these parameters is most significant in patients with combination of the two drugs. Conclusion: Combined losartan and lotensin decreases MABP, 24h urine protein excretion, Scr and BUN to a greater extent than losartan or lotensin alone.