替米沙坦与前列地尔和川芎嗪联用治疗糖尿病肾病蛋白尿合并高血压临床疗效观察  

The clinical effect of Telmisartan,Alprostadil combined with Tetramethylpyrazine in patients with hypertension and diabetic nephropathy

作　　者：呼双琴[1] 徐杰[1] 倪高顺 

机构地区：[1]延安大学附属医院内分泌科,陕西延安716000 [2]商洛市中心医院呼吸内科,陕西商洛726000

出　　处：《临床和实验医学杂志》2016年第19期1902-1906,共5页Journal of Clinical and Experimental Medicine

摘　　要：目的评价替米沙坦,前列地尔与川芎嗪联合用于糖尿病肾病蛋白尿合并高血压的临床疗效。方法选取2013年1月至2015年1月接受治疗的82例糖尿病肾病蛋白尿合并高血压患者作为研究对象,随机分为两组。所有患者均给予降血糖,降血压等常规治疗。对照组患者在此基础上给予替米沙坦联合前列地尔治疗;观察组则在对照组基础上另给予川芎嗪治疗。两组治疗周期均为6周。观察并检测治疗前后两组患者血压(舒张压/收缩压)、血脂[低密度脂蛋白胆固醇(LDL-C)、甘油三脂(TG)及总胆固醇(TC)]、空腹血糖值(FBG)、肾功能[尿素氮(BUN),血肌酐(Cr)及内生肌酐清除率(Ccr)]和尿蛋白定量值(UPE)改善情况。结果治疗后,两组患者UPE均明显降低,治疗第6周,观察组UPE为2.32 g/24 h,明显低于对照组的2.89 g/24 h;治疗后,观察组患者BUN,Cr及Ccr分别为(16.7±4.3)mmol/L、(365.8±17.8)mmol/L及(29.0±2.9)ml/min,均明显低于对照组;两组患者治疗后TC、LDL-C及TG含量均明显降低,两组治疗前后相比较,差异均具有统计学意义(P<0.05);治疗后,观察组TC、LDL-C及TG含量明显低于对照组,差异均具有统计学意义(P<0.05)。两组患者经过治疗FBG及血压值均明显降低,而观察组FBG降低程度明显优于对照组,两组血压值则无显著差异。结论替米沙坦,前列地尔与川芎嗪联合治疗糖尿病肾病蛋白尿合并高血压不仅能够有效改善患者肾功能,减少蛋白尿,还能够有效降低患者血糖及血脂水平,延缓糖尿病肾病的进展,值得进一步研究。Objective To evaluate the clinical application of telmisartan, alprostadil combined with tetramethylpyrazine in patients with hypertension and diabetic nephropathy. Methods From January 2013 to January 2015 , 82 cases of hypertension and diabetic nephropathy patients in our department were divided two groups, observation group and control group. All patients were given control blood sugar, blood pressure and other conventional treatment. The treatment of control group patients were based on the basis of telmisartan united fronts treatment. Observation group was treated with tetramethylpyrazine in the base of control group. Treatment cycle was six weeks. The hypertension （diastolic pressure/ systolic blood pressure） , fasting blood glucose （FBG） , kidney [ BUN （ urea nitrogen） , Cr （serum creatinine） and Ccr （ endogenous creatinine clearance） ] and urine protein quantitative values（UPE） were detected before and after the treatment. Results After treatment, the UPE in two groups of patients were significantly lower, the UPE of observation group was 2. 32 g/24 h, significantly lower than the control group of 2. 89 g/24 h. After treatment, BUN, Cr and Ccr of the observation group were （16.7 ±4.3） mmol/L, （365. 8 ± 17. 8 ） mmol/L and （29. 0 ± 2. 9） ml/ min, respectively, were significantly lower than those of the control group. After treatment, TC , LDL - C and TG levels in two groups were signifi-cantly decreased compared with before treatment, the differences were statistically significant （ P 〈0. 0 5） . After treatment, TC , LDL - C and TG the observation group were significantly lower than those of the control group, the differences were statistically significant （ P 〈0. 0 5） . FBG and blood pressure values of treatment group were significantly lower than those before the treatment, and the decreased extent of FBG of the observation group was superior than that of control group, no difference of blood pressure values was found b

关 键 词：糖尿病肾病 高血压 替米沙坦 前列地尔 川芎嗪 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学] R544.1[医药卫生—临床医学]