氯沙坦联合卡托普利治疗早期糖尿病肾病的临床研究  

Clinical study of losartan combined with captopril in patients with early diabetic nephropathy

作　　者：王苏杭[1] 朱江[1] 吴丽颖[1] 宗伟钧[1] 张淑华[1] 孙文君[1] 程训民[1] 朱晴[1] 

机构地区：[1]安徽省淮北市人民医院内科,安徽淮北235000

出　　处：《安徽医药》2005年第4期257-259,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨氯沙坦联合卡托普利治疗早期糖尿病肾病(DN)的临床疗效及安全性,为临床合理选择用药提供依据。方法88例2型糖尿病肾病患者随机分为3组,分别为氯沙坦组、卡托普利组及联合用药组,疗程均为24周。观察治疗前后各组收缩压(SBP)、舒张压(DBP)、尿白蛋白排泄率(UAER)、血尿素氮(BUN)、血肌酐(Cr)、糖化血红蛋白(HbA1c)、血钾(K+ )、血总胆固醇(CH)、甘油三酯(TG)变化。结果联合用药组、氯沙坦组和卡托普利组治疗早期DN,均有明显降压、降尿蛋白的作用,各组治疗前后比较差异有显著性(P<0. 01、P<0. 05);联合用药组舒张压降低程度与单独用药两组比较,差异有显著性(P<0.05);联合用药组UAER降低幅度较氯沙坦组和卡托普利组明显,分别为59%、53%、50%;各组BUN、Cr、HbA1c、K+、CH、TG治疗前后及各组间比较无统计学意义(P>0. 05)。结论氯沙坦联合卡托普利治疗早期糖尿病肾病更有效、更合理,并无明显不良反应。Aim To evaluate the clinical efficacy and safety of losartan combined with captopril in patients with early diabetic nephropathy （DN） , so as to provide the rationality of clinical medication. Methods Eighty-eight patients with DN were randomly divided into three groups： group A received losartan, group B captopril and group C losartan combined with captopril for 24 weeks. Systolic blood pressure （SBP）, Diastolic blood pressure （DBP）, urinary albumin excretion rate （UAER）, serum BUN, Cr, HblAc, potassium （ K^＋ ） , CH and TG were observed. Results There were significant differences （ P 〈 0.01 , P 〈 0.05 ） in decreasing BP and urinary protein after treatment among three groups. As compared with patients in group A and group B, blood diastolic pressure were decreased markedly in patients of group C（ P 〈 0.05）. UAER were decreased markedly in group C, the decreasing rate was 59% ,53% ,50% respectively. There were no differences in serum levels of BUN, Cr, Hbl Ac, potassium, CH and TG after treatment among three groups （P 〉 0.05）. Conclusion Losartan combined with captopril was more effective and rational in treating patients with early DN without side effect.

关 键 词：氯沙坦 联合用药 卡托普利 药物治疗 糖尿病肾病 舒张压 血肌酐 糖化血红蛋白 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]