氯沙坦和贝那普利联合治疗早期糖尿病肾病的疗效观察(1)
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[摘要] 目的：探讨氯沙坦(LOS)和贝那普利(BEN)联合治疗(COM)早期糖尿病肾病(DN)尿清蛋白排泄率(UAER)的影响。方法：62例符合入选条件的患者被随机分成三组,①LOS组21例，LOS 50～100 mg/d。②BEN组20例，BEN 10～20 mg/d。③COM组21例，LOS(25～50 mg)+BEN(5～15 mg/d)。三组血压控制目标为130/80 mm Hg(1 mm Hg=0.133 kPa)以下，疗程为8周。三组在治疗前后用放射免疫法测定UAE，同时还测定血压、肾功能、血糖、糖化血红蛋白(HbA1c)和血钾等。结果：三组治疗前后血压均显著下降，差异有统计学意义(P<0.01)；但三组间比较，差异无统计学意义(P>0.05)。三组UAE治疗后较治疗前均有显著下降(P<0.01)，分别为LOS组(138±37) mg/24 h与(94±26) mg/24 h，BEN组(139±36) mg/24 h与(92±23) mg/24 h，COM组(140±39) mg/24 h与(52±20) mg/24 h。治疗8周后，LOS组与BEN组的UAE比较差异无统计学意义(P>0.05)，COM组UAE显著低于LOS组和BEN组(P<0.01)。COM组副作用发生率最低。结论：LOS和BEN联合用药降低DN患者UAE疗效优于单一用药，且副作用少。
[关键词] 糖尿病肾病；高血压；白蛋白尿；联合治疗
[中图分类号] R587.2[文献标识码]C [文章编号]1673-7210(2008)11(c)-039-03
Effects of combination of Losartan and Benazepril in the patients with early diabetic nephropathy
WANG Hui-xin1, DOU Lian-jun2
(1.Department of Nephrology, Xuzhou Central Hospital, Jiangsu Province, Xuzhou221009, China; 2.Department of Endocrinology, Xuzhou Central Hospital, Jiangsu Province, Xuzhou221009, China)
[Abstract] Objective: To explore the effect of combination therapy (COM) with Losartan (LOS) and Benazepril (BEN) on urinary albumin excretion rata (UAER) in the patients with early diabetic nephropathy. Methods: 62 cases were randomly divided into three groups, ①LOS group consisted of 21 cases, treated with LOS 50-100 mg/d.②BEN group of 20 cases, treated with BEN 10-20 mg/d.③COM group of 21 cases, treated with LOS 25-50 mg/d plus BEN 5-15 mg/d. A goal of blood pressure (BP) control was 130/80 mm Hg or less in the three groups. Treatment period lasted for 8 weeks. The levels of UAE were measured by radioimmunoassay before and after treatment. These results were converted into logarithmic values. We also measured BP, renal function, fasting blood glucose, glycosylated hemoglobin and blood potassium levels ......
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