摘要
目的探讨血管紧张素转换酶抑制剂（ACEI）联用血管紧张素Ⅱ型受体（AT-Ⅱ）拮抗剂治疗早期糖尿病肾病的合理性。方法60例2型糖尿病并发的早期糖尿病肾病患者，随机分为贝那普利组（n=20）、厄贝沙坦组（n=20）及两药联用组（n=20）治疗18周，治疗前后对平均动脉压（MAP）、尿白蛋白排泄率（UAER）、内生肌酐清除率（OD）、血清肌酐（Scr）、血清尿素氮（BUN）、空腹血糖（FBG）、餐后2h血糖（2hBG）、糖化血红蛋白（HbA1c）、血脂分析、血清钾进行比较。结果贝那普利组UAER治疗后比治疗前下降了33．9％（t=3．278，P=0．004），厄贝沙坦组下降了36．2％（t=4．234，P〈0．01），两药联用组（贝那普利＋厄贝沙坦）下降了60．9％（t=5．754，P〈0．01），两单药组间下降幅度无明显差异（P〉0．05），联用组较单药组下降幅度总体增加26．1％。结论ACIEI与AT1拮抗剂联合应用治疗早期糖尿病肾病有一定的临床价值。
Objective To detect the rationality of treating early diabetic nephropathy with the combination of angiotensin converting enzyme inhibition（ACEI） and angioteus in type Ⅱ receptor（AT- Ⅱ ） antagonist. Methods 18 weeks long therapy was perfomed in 60 patients with type 2 diabetes and early diabetic nephropathy. 20 cases seiected by chance were cured with benazpril. An other 20 cases selected by chance were cured with irbesartan. The rest 20 cases were cured with the combination of benazpril and irbesartan. The examinations were performed to every patient to determine parameters such as the mean arterial pressure（MAP）, urinary albumin excretion rate（UAER）, endogenous creatinine clearance （CCr）, serum creatinine （ Scr）, blood urea nitrogen （ BUN ）, fasting blood glucose （FBG） ,2h blood glucose（2hBG）,hemoglobin Alc（HbAlc） ,blood lipid and serum potassium. Results The UAER descended 33.9 % in benazpril group （ t = 3. 278, P = 0. 004 ）, 36.2 % in irbesartan group （ t = 4. 234, P 〈 0.01 ）, and 60.9 % in benazpril ＋ irbesartan group （ t = 5. 753, P 〈 0.01 ）. There was no obvious difference between benazpril group and irbesartan group（P 〉 0.05 ）. The descent amplitude of benazpirl ＋ irbesartan group was 26.1% higher than that of group benazpirl group and irbesartan group. Conclusion It is a safe way to treat early diabetic nephropathy with the combination of ACEI and AT- Ⅱ antagonist.
出处
《中国基层医药》
CAS
2007年第3期437-438,共2页
Chinese Journal of Primary Medicine and Pharmacy
