依那普利联合苯磺酸氨氯地平对糖尿病肾病伴高血压患者血清炎性因子及肾功能的影响  

The impact of inflammatory factors and renal function of enalapril combined with amlodipine besylate for diabetic nephropathy with hypertension

作　　者：李钰艳[1] 吴艳[1] 喻荷淋[1] 付彩雯[1] 刘阳[1] 黄秀丽[1] Li Yuyan;Wu Yan;Yu Helin;Fu Caiwen;Liu Yang;Huang Xiuli(Department of Endocrinology and Metabolism, Suining Central Hospital, Sichuan Province Suining 629000, China)

机构地区：[1]四川省遂宁市中心医院内分泌代谢病科,629000

出　　处：《疑难病杂志》2021年第8期761-764,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：四川省中医药管理局科学技术研究专项课题(2020LC0215)。

摘　　要：目的探讨依那普利联合苯磺酸氨氯地平在糖尿病肾病(DN)伴高血压患者中的应用效果。方法选择2019年6月—2020年5月四川省遂宁市中心医院内分泌代谢病科收治的DN伴高血压患者85例为研究对象,采用分层随机法分为观察组43例、对照组42例。2组患者均常规给予二甲双胍、胰岛素等控制血糖,对照组同时给予依那普利治疗,观察组同时给予依那普利联合苯磺酸氨氯地平治疗。治疗8周后,比较2组治疗前后血压与血糖、炎性因子、肾功能指标水平,以及不良反应。结果治疗8周后,观察组患者收缩压(SBP)、舒张压(DBP)低于对照组(t/P=3.875/0.002,5.234/0.000);血清白介素-6(IL-6)、高敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平低于对照组(t/P=6.548/0.000,14.705/0.000,5.281/0.000);24 h尿蛋白定量(24 hUPr)、血肌酐(SCr)、尿素氮(BUN)低于对照组(t/P=7.531/0.000,3.864/0.002,3.072/0.008)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论依那普利联合苯磺酸氨氯地平有助于控制DN伴高血压患者血压水平,改善肾功能,可能与拮抗炎性反应等因素有关。Objective To study effect of enalapril combined with amlodipine besylate in treatment of diabetic nephropathy(DN)with hypertension.Methods 85 DN with hypertension from June 2019 to May 2020 were divided into observation group(n=43)and control group(n=42).All patients given metformin and insulin therapy,the control group given enalapril therapy at the same time,the observation group given enalapril combined with amlodipine besylate therapy.8 weeks after therapy,blood pressure adn blood glucose,inflammatory factors,renal function,adverse reactions were compared between two groups.Result The SBP,DBP of observation group was lower than that of control group(t/P=3.875/0.002,5.234/0.000).Serum IL-6,hs-CRP,TNF-αwas lower than that of control group(t/P=6.548/0.000,14.705/0.000,5.281/0.000).24hUPr,SCr,BUN was lower than that of control group(t/P=7.531/0.000,3.864/0.002,3.072/0.008).There was no significant difference between two groups in adverse effects(P>0.05).Conclusion Enalapril combined with amlodipine besylate help to control blood pressure level,and improve renal function,which may be related to anti-inflammatory reaction.

关 键 词：糖尿病肾病 高血压 依那普利 苯磺酸氨氯地平 炎性因子 肾功能 

分 类 号：R544.1[医药卫生—心血管疾病] R587.2[医药卫生—内科学]