坎地沙坦联合贝那普利治疗糖尿病肾病并高血压患者的临床研究

目的:探索坎地沙坦联合贝那普利治疗糖尿病肾病(DN)并高血压患者的临床疗效。方法:选择2012年7月至2014年9月我院接收的DN合并高血压患者135例,按照随机数表法将患者分成坎地沙坦组(口服8 mg/d坎地沙坦)、贝那普利组(口服10mg/d贝那普利)和联合用药组(口服8 mg/d坎地沙坦和10 mg/d贝那普利)三组,每组45例,连续治疗12周。比较三组患者治疗前后收缩压(SBP)、舒张压(DBP)、24 h尿微量清蛋白排泄频率(24 h UAER)、尿素氮(BUN)、血钾水平(K+)、血清肌酐(Scr)、肌酐清除率(Ccr)、空腹血糖(FPG)指标变化及不良反应发生率。结果:与治疗前相比,治疗后各组患者的SBP、DBP、24 h UAER及BUN、Scr、Ccr、FPG均显著下降(均P0.05),且联合用药组患者的上述各指标水平明显低于坎地沙坦组和贝那普利组(均P0.05);联合用药组不良反应发生率低于其他两组,但是三组之间差异无统计学意义(P0.05)。结论:坎地沙坦联合贝那普利可以有效改善DN并高血压患者的血压情况及尿蛋白水平,改善患者的肾脏功能,且疗效优于单药治疗,对于临床用药有指导意义。

Clinical Research on Candesartan Combined with Benazepril for Patients with Diabetic Nephropathy and Hypertension

Objective:To explore the clinical effect of candesartan combined with benazepril in the treatment of patients with diabetic nephropathy (DN) and hypertension.Methods:A total of 135 patients with DN and hypertension, who were treated in Second Artillery General Hospital of Beijing from July 2012 to September 2014, were randomly divided into candesartan group (oral administration of 8mg/d of candesartan, n=45), benazepril group (oral administration of 10mg/d of benazepril, n=45) and combination group (oral administration of 8 mg/d of candesartan and 10mg/d of benazepril, n=45). All the patients of the three groups were given continuous treatment for 12 weeks. Then the changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), 24 h urine trace albumin excretion rate (24 h UAER), urea nitrogen (BUN), potassium (K+), serum creatinine (Scr), creatinine clearance (Ccr), fasting plasma glucose (FPG) before and after treatment and the incidence of adverse reactions in the three groups were compared.Results:Compared with before treatment, the levels of SBP, DBP, 24 h UAER and BUN, Scr, Ccr, and FPG in the three groups after treatment significantly decreased (P<0.05), and the levels of above indexes after treatment and the incidence of adverse reaction in combination group were significantly lower than those in the other two groups(P<0.05). But there was no statistically significant difference among the three groups (P>0.05).Conclusion:Candesartan combined with benazepril can effectively improve the blood pressure and the level of urine protein, and the kidney function of the patients with DN and hypertension, its effect is better than the single drug therapy, which can be used as a guidance for clinical medication.