ACEI类药物治疗糖尿病肾病的临床疗效观察(1)
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[摘要] 目的：探讨ACEI类药物治疗糖尿病肾病的临床疗效。方法：将本院糖尿病专科2009年4月～2010年10月收治的120例患者按照随机数字表随机分成3组，①血管紧张素转换酶抑制剂(ACEI)组，给予贝那普利治疗；②血管紧张素受体拮抗剂(ARB)组，给予缬沙坦治疗；③ACEI+ARB联合用药组，给予缬沙坦与贝那普利。统计分析患者治疗前后24 h内的尿蛋白以及血肌酶变化情况，并观察比较各组的耐受性、临床效果与不良反应。结果：ACEI组、ARB组、联合用药组治疗3个月后尿蛋白分别为0.729、1.000、0.825 g/L，治疗6个月后分别为0.500、0.375、0.305 g/L，ACEI组、ARB组患者的治疗3、6个月后的尿蛋白及血肌酶变化对比联合用药有一定差异(P<0.05)。结论：ACEI类药物进行联合用药对糖尿病患者的肾功能保护作用会更加明显。
[关键词] ACEI类药物；ARB类药物；糖尿病肾病；并发症
[中图分类号] R587.2 [文献标识码] A [文章编号] 1674-4721(2012)01(a)-055-02
The clinical effect analysis of ACEI for the diabetic nephropathy
ZHANG Mengmeng
Department of Medical, People's Hospital of Jianggan District, Zhejiang Province, Hangzhou 310021, China
[Abstract] Objective: To investigate the clinical efficacy of ACEI drugs in treatment of diabetic nephropathy. Methods: In our hospital diabetes specialist April 2009 to October 2010 120 patients were randomly divided into three groups according to random number table, ① angiotensin-converting enzyme inhibitor (ACEI) group, were given benazepril; ② angiotensin receptor blocker (ARB) group were given valsartan; ③ ACEI and ARB combination treatment group, were given valsartan and benazepril. Statistical analysis before and after treatment within 24 h urine protein and serum muscle enzyme changes, and the tolerance of each group, the clinical effects and adverse reactions were observed. Results: Urinary protein of ACEI group, ARB group, the combined treatment group were 0.729, 1.000, 0.825 g/L after 3 months treatment respectively, and 0.500, 0.375, 0.305 g/L after 6 months of treatment, ACEI group, ARB treatment of patients 3 months, 6 months after the urine protein and serum muscle enzymes in combination with certain changes in contrast differences (P<0.05). Conclusion: ACEI drug combination therapy for patients with diabetes the protective effect of renal function is more obvious.
[Key words ] ACEI drugs; ARB drugs; Diabetic nephropathy; Complications
糖尿病肾病是糖尿病发展过程中最为严重的微血管类并发症，是导致糖尿病患者死亡并且终末期因肾病透析造成自身重大痛苦的最为关键的原因之一[1]。临床上并发高血压率高达80%～90%，糖尿病肾病与高血压之间是相互促进并互为因果的 ......
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