氯沙坦联合硝苯地平对老年2型糖尿病肾病并高血压的疗效及肾功能改善作用

目的研究氯沙坦片联合硝苯地平控释片对于治疗老年2型糖尿病肾病合并高血压的疗效及肾功能改善情况。方法选择2013年6月至2014年8月收治的老年2型糖尿病肾病合并高血压患者85例，随机分成观察组43例和对照组42例。观察组患者采用氯沙坦片联合硝苯地平控释片进行治疗，对照组患者仅用硝苯地平控释片进行治疗。结果治疗后，观察组患者的血尿素氮、血肌酐、血尿酸及尿微量白蛋白含量等各项指标均明显降低，但对照组上述指标仅有较小程度的降低，观察组的疗效明显优于对照组。治疗后，观察组患者的收缩压和舒张压均明显降低，且其平均值符合正常血压范围。但对照组患者治疗后，不论收缩压还是舒张压降低程度均较小。从血压降低效果来看，观察组显著有效患者15例，多于对照组的9例；有效18例，同样多于对照组；无效10例，明显少于对照组。观察组的整体有效率达76．74％，明显高于对照组的50．00％。结论氯沙坦片联合硝苯地平控释片治疗老年2型糖尿病肾病合并高血压疗效较好，可有效降低血压，促进肾功能改善。值得临床推广。

Objective To analyze the treatment and renal function improvement of Losartan combined with nifedipine for the treatment of elderly patients with type 2 diabetic nephropathy and hypertension.Methods 85 cases of elderly patients with type 2 diabetic nephropathy and hypertension from June 2013 to August 2014 in our hospital were studied,and were randomly divided into observation group and control group.Wherein the observation group were treated with Losartan joint nifedipine.The patients in the control group only used nifedipine for treatment.Results After treatment,the indexes of observation group about BUN, creatinine,uric acid and urinary albumin content had significantly reduced,achieved a more satisfactory therapeutic effect.But the control group only had a lesser extent,indicating the treatment effect was not obvious.Overall speaking,the therapeutic effect of the observation group was significantly better than the control group.After the treatment,the observation group systolic and diastolic blood pressure had significantly reduced,and the average value in line with normal blood pressure range.But the control group patients,whether systolic or diastolic blood pressure,the smaller the extent of their reduced.Overall speaking,the treatment of patients in the observation group than the control group.From blood pressure lowering effect of overall comparison,the observation group was significantly effective in patients with 15 cases,more than the control group 9 cases;17 cases of patients with effective,as more than the control group; 11 cases were ineffective,significantly less than the control group.And the observation group in the overall effective rate of 76.74%,significantly higher than the 50.00% percent.Conclusion Losartan joint nifedipine for the treatment of elderly patients with type 2 diabetic nephropathy patients with hypertension have a good therapeutic effect,can effectively lower blood pressure, promote the improvement of renal function should be introduced in clinical medicine.