摘要
目的观察大剂量血管紧张素转换酶抑制剂联合血管紧张素受体拮抗剂治疗糖尿病肾病的疗效。方法68例糖尿病肾病患者被随机分为常规剂量雷米普利组和大剂量雷米普利组，均联合同等剂量的替米沙坦。治疗方案：常规剂量组给予雷米普利2．5mg／次，2次／d，口服。大剂量组给予雷米普利5mg/次，2次／d，口服。两组均联合应用替米沙坦80mg／d，观察治疗后3个月和6个月后，两组24h尿蛋白定量、血浆白蛋白、血肌酐、血钾水平以及血压的变化。结果两组在治疗6个月后24h尿蛋白定量均下降，血浆白蛋白均升高，与治疗前相比差异具有显著意义（P〈0．05）；大剂量组上述指标的变化更明显，与常规剂量组相比差异具有显著性（P〈0．05）；均能有效降压，大剂量雷米普利组降舒张压优于常规剂量组；两组治疗前后血钾和肾功能无统计学意义（P〉0．05）。结论大剂量血管紧张素转换酶抑制剂治疗糖尿病肾病安全，联合血管紧张素受体拮抗剂治疗有双重阻断。肾素血管紧张素系统的作用，并且大剂量血管紧张素转换酶抑制剂联合血管紧张素受体拮抗剂更有效。
Objective To observe effect of high dose ramipril combined with telmisartan on diabetic nephropathy. Methods 68 patients with clinical diabetic nephropathy were randomly divided into routine dose group and high dose group. In routine dose group, ramipril 2.5 mg each time was given, twice daily, where as in high dose group, ramipril 5 mg each time was given, twice daily. Both groups were combined with telmisartan 80 mg daily. 24 - hour urine protein, serum albumin, serum creatinine, potassium and blood pressure were observed after 3 months and 6 months. Results In two groups, the 24 - hour urine protein was decreased, while serum albumin was increased after 6 months, the difference was significant （P 〈0. 05 ）. High dose therapy had more significant effect compared with the routine dosage（ P 〈 0. 05 ） ; Both therapy could effectively lower blood pressure, and the high dose group lowered diastolic blood pressure better than the routine dose group ; Serum potassium and renal function didn＇t significantly changed （ P 〉 O. 05 ）. Conclusion High dose of angiotensin - converting enzyme inhibitor（ACEI） can treat diabetic nephropathy safely, and have a double blocking effect on the lenin - angiotensin system （RAS） when combined with angiotensin -receptor antagonist（ARB）. High dose of angiotensin -converting enzyme inhibitor （ACEI） combined with angiotensin -receptor antagonist （ARB） was more effective .
出处
《中国医学创新》
CAS
2009年第19期5-6,共2页
Medical Innovation of China
