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作 者:徐永权[1] 刘海[1] 董雯丽 XU Yongquan;LIU Hai;DONG Wenli(Gansu Rehabilitation Center Hospital,Lanzhou 730000,China;不详)
出 处:《中外医学研究》2024年第16期9-13,共5页CHINESE AND FOREIGN MEDICAL RESEARCH
摘 要:目的:探讨依那普利与氯沙坦二联疗法治疗老年糖尿病肾病(DN)伴高血压患者的效果。方法:选取2021年1月—2022年12月甘肃省康复中心医院收治的160例老年DN伴高血压患者作为研究对象,按信封随机法分成试验组、对照组,各80例。对照组施行单一氯沙坦治疗,试验组施行依那普利与氯沙坦二联疗法,比较两组临床疗效、肾功能指标、血压、血清可溶性肿瘤坏死因子受体Ⅰ(sTNFRⅠ)、可溶性CD146(sCD146)、胎球蛋白A(Fetuin-A)水平。结果:试验组总有效率为93.75%,高于对照组的83.75%,差异有统计学意义(P<0.05)。治疗8周后,两组肌酐、脑钠肽、尿酸、舒张压、收缩压均低于治疗前,且试验组均低于对照组,差异有统计学意义(P<0.05)。治疗8周后,两组sTNFRⅠ与sCD146均低于治疗前,Fetuin-A高于治疗前,且试验组sTNFRⅠ与sCD146低于对照组,Fetuin-A高于对照组,差异有统计学意义(P<0.05)。结论:采用依那普利与氯沙坦二联疗法治疗老年DN伴高血压患者的效果显著,有助于上调血清Fetuin-A表达,改善其肾功能指标,降低血压水平,并促进血清sTNFRⅠ、sCD146水平降低。Objective:To investigate the effect of Enalapril combined with Losartan in the treatment of elderly patients with diabetic nephropathy(DN)and hypertension.Method:A total of 160 elderly patients with DN and hypertension admitted to the Gansu Rehabilitation Center Hospital from January 2021 to December 2022 were selected as the study objects,and they were divided into experimental group and control group by envelope random method,with 80 cases in each group.The control group received single Losartan treatment,and the experimental group received combination therapy with Enalapril and Losartan.The clinical efficacy,renal function indexes,blood pressure,levels of serum soluble tumor necrosis factor receptorⅠ(sTNFRⅠ),soluble CD146(sCD146)and Fetuin-A were compared between the two groups.Result:The total effective rate of experimental group was 93.75%,which was higher than 83.75%of control group,and the difference was statistically significant(P<0.05).After 8 weeks of treatment,creatinine,brain natriuretic peptide,uric acid,diastolic blood pressure and systolic blood pressure in two groups were lower than those before treatment,and those in the experimental group were lower than those in the control group,the differences were statistically significant(P<0.05).After 8 weeks of treatment,sTNFRⅠand sCD146 in two groups were lower than those before treatment,Fetuin-A was higher than that before treatment,and sTNFRⅠand sCD146 in experimental group were lower than those in control group,Fetuin-A was higher than that in control group,the differences were statistically significant(P<0.05).Conclusion:The combination therapy of Enalapril and Losartan has a significant effect in the treatment of elderly patients with DN and hypertension,which helps to up-regulate the expression of serum Fetuin-A,improve renal function indicators,reduce blood pressure,and promote the reduction of serum sTNFRⅠand sCD146 levels.
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