盐酸贝尼地平片联合银杏酮酯片治疗老年高血压合并2型糖尿病肾病疗效观察

Observation of efficacy of benidipine hydrochloride tablets combined with ginkgo ketoester tablets in the treatment of elderly hypertensive patients with type 2 diabetic nephropathy

目的:观察盐酸贝尼地平片联合口服银杏酮酯片治疗老年高血压合并2型糖尿病肾病的临床疗效。方法:选取2019年1月—2021年6月天山中医医院及上海市长宁区北新泾街道社区卫生服务中心诊治的老年高血压合并2型糖尿病肾病患者100例,随机分为两组。对照组给予盐酸贝尼地平片治疗,4~8 mg/d,1次/d;观察组在对照组基础上口服银杏酮酯片,1粒/次,3次/d。治疗12个月后比较两组患者临床总有效率,并在治疗1个月、3个月、12个月后分别比较两组肾功能指标、血压和血糖值,比较两组再住院率和死亡率及不良反应发生率变化。结果:治疗12个月后,观察组总有效率为96.00%,高于对照组的76.00%(P<0.05)。观察组尿微量白蛋白(mALB)、β2-微球蛋白(β2-MG)、血清半胱氨酸蛋白酶抑制剂C(Cys-C)、血肌酐(Scr)、血浆N末端脑钠肽前体(NT-pro BNP)值均低于对照组(P<0.05),而肾小球滤过率(eGFR)值则高于对照组(P<0.05);观察组血压、空腹血糖(FPG)、餐后2 h血糖(2 h PG)和糖化血红蛋白(HbA1c)值在治疗后均较对照组有所降低(P<0.05)。观察组再住院率、死亡率低于对照组(P<0.05),不良反应发生率与对照组比较差异无统计学意义(P>0.05)。结论:盐酸贝尼地平片与银杏酮酯片联合治疗老年高血压合并2型糖尿病肾病,可改善患者各项指标,提高临床疗效。

Objective:To observe the clinical efficacy of benidipine hydrochloride tablets combined with oral administration of ginkgo ketoester tablets in the treatment of the elderly hypertensive patients with type 2 diabetic nephropathy.Methods:One hundred elderly patients with hypertension combined with type 2 diabetic nephropathy were collected from Tianshan Hospital of Traditional Chinese Medicine,and Beixinjing Community Health Service Center of Shanghai from Jan.2019 to June 2021 and randomly divided into two groups.The control group was treated with benidipine hydrochloride tablets 4-8 mg/d,once a day;the observation group was treated with ginkgo ketoester tablets 1 pill/time,3 times/d on the basis of the control group.After 12 months of treatment,the clinical total effective rate between the two groups was compared.And after 1 month,3 months and 12 months of treatment renal function index,blood pressure and blood glucose value,and the change of rehospitalization rate,mortality and adverse reaction rate between the two groups were compared.Results:After 12 months of treatment,the total effective rate in the observation group was 96.00%,which was higher than 76.00%in the control group(P<0.05).Urinary microalbumin(mALB),β2-microglobulin(β2-MG),serum cysteine protease inhibitor C(Cys-C),serum creatinine(Scr)and plasma N-terminal pro-brain natriuretic peptide(NT-pro BNP)values in the observation group were lower than those in the control group(P<0.05),the glomerular filtration rate(eGFR)in the observation group was higher than that in the control group(P<0.05);the values of blood pressure,fasting blood glucose(FPG),postprandial blood glucose(2 h PG)and glycosylated hemoglobin(HbA1c)in the observation group were lower than those in the control group after treatment(P<0.05).The rehospitalization rate and mortality rate in the observation group were lower than those in the control group and there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Benidipine hydrochloride tablets combined with ginkgo ketoester tablets in the treatment of elderly hypertensive patients with type 2 diabetic nephropathy can improve various indicators of patients and improve clinical efficacy.