贝那普利联合缬沙坦对老年糖尿病肾病患者血压和肾功能指标的影响

Effects of Benazepril Combined with Valsartan on Blood Pressure and Renal Function in Elderly Patients with Diabetic Nephropathy

目的:观察贝那普利联合缬沙坦对老年糖尿病肾病患者血压和肾功能指标的影响。方法:90例老年糖尿病肾病患者按随机数字表法均分为贝那普利组、缬沙坦组和联合用药组。3组患者均给予糖尿病健康教育指导,包括饮食控制、稳定运动量、戒烟限酒和生活行为习惯指导等,同时通过肌肉注射胰岛素或口服降糖药物控制空腹血糖小于7.0 mmol/L,餐后2 h血糖小于10mmol/L。在此基础上,贝那普利组患者给予盐酸贝那普利片10 mg,口服,每日1次;缬沙坦组患者给予缬沙坦胶囊80 mg,口服,每日1次;联合用药组给予盐酸贝那普利片(用法用量同贝那普利组)+缬沙坦胶囊(用法用量同缬沙坦组)。3组患者疗程均为3个月。观察3组患者治疗前后平均动脉压(MAP)、尿蛋白排出量(UAE)、血肌酐(Scr)、尿素氮(BUN)、尿酸(UA)、β2-微球蛋白、血清同型半胱氨酸(Hcy)、胱抑素C(Cys-C)及不良反应发生情况。结果:治疗前3组患者MAP、UAE、Scr、BUN、UA、Hcy、Cys-C、β2-微球蛋白水平比较,差异无统计学意义(P>0.05);治疗后3组患者MAP、UAE、Scr、BUN、Hcy、Cys-C、β2-微球蛋白水平均显著低于同组治疗前,且联合用药组低于贝那普利组和缬沙坦组;UA显著高于同组治疗前,且联合用药组高于贝那普利组和缬沙坦组,差异有统计学意义(P<0.05);上述各项指标贝那普利组与缬沙坦组间比较,差异无统计学意义(P>0.05)。3组患者治疗期间均未见明显不良反应发生。结论:贝那普利联合缬沙坦可显著改善老年糖尿病肾病患者血压和肾功能指标的水平,且安全性较好。

OBJECTIVE：To observe the effects of benazepril combined with valsartan on blood pressure and renal function in elderly patients with diabetic nephropathy. METHODS：90 elderly patients with diabetes nephropathy were randomly divided into benazepril group,valsartan group and drug combination group. 3 groups were all given type 2 diabetes health education guidance,including alimentary control,stable amount of exercise,quitting smoking and stopping drinking,guide for living habits,etc. and intramuscular injection of insulin or oral dose of hypoglycemic agents to control fasting blood glucose〈 7.0 mmol/L,2 h postprandial blood glucose10 mmol/L. On this basis,benazepril group was additionally given Benazepril hydrochloride tablet 10 mg orally,once a day;valsartan group was additionally given Valsartan capsule 80 mg orally,once a day;drug combination group was given Benazepril hydrochloride tablet＋Valsartan capsule（same usage and dosage as above 2 groups）. Treatment course of 3 groups lasted for 3 months. MVP,urinary protein excretion（UAE）,Scr,BUN,UA,β2-microglobulin,Hcy,Cys-C and ADR were detected in 3 groups. RESULTS：MAP,UAE,Scr,BUN,UA and β2-microglobulin of 3 groups had no statistically significant difference before treatment（P〉0.05）. MAP,UAE,Scr,BUN,Hcy,Cys-C and β2-microglobulin of 3 groups after treatment were significantly lower than before,and the drug combination group was lower than other 2 groups. UA of 3 groups after treatment was significantly higher than before,and the drug combination group was higher than other 2 groups;there was statistical significance（P〈0.05）;but there was no statistical significance between benazepril group and valsartan group（P〉0.05）. No obvious ADR was found in 3 groups during treatment. CONCLUSIONS：Benazepril combined with valsartan can significantly improve the levels of blood pressure and renal function in the elderly patients with diabetic nephropathy with good safety.