缬沙坦联合贝那普利治疗早期糖尿病肾病的临床疗效.docx

缬沙坦联合贝那普利治疗早期糖尿病肾病的临床疗效[摘要]目的：探讨缬沙坦联合贝那普利治疗糖尿病肾病的临床疗效。方法：将78例合并早期糖尿病肾病的2型糖尿病患者随机分为3组每组各26例。缬沙坦组应用缬沙坦80mg/d贝那普利组应用贝那普利10mg/d联合用药组应用贝那普利10mg/d＋缬沙坦80mg/d。观察各组治疗前后24h尿白蛋白排泄率(UAER)、平均动脉压(MAP)、肾功能等指标的变化。结果：治疗16周患者尿蛋白均有不同程度下降联合组尿蛋白下降程度明显优于单一用药组差异有显著性意义（P0.05）无严重不良反应发生。结论：缬沙坦联合贝那普利治疗糖尿病肾病可有效降低血压明显降低尿蛋白防止DN的进展提高患者生存状况。[关键词]糖尿病肾病；缬沙坦；贝那普利；尿白蛋白排泄率[中图分类号]R587.2[文献标识码]C[文章编号]1673-7210（2008）08（b）-071-02ClinicalobservationofvalsartanandbenazeprilinthetreatmentofdiabeticnephropathyHUANGHuiLIMing-zhengLIUMing-ming（DepartmentofEndocrinologytheSecondPeople'sHospitalofShenzhenShenzhen5180２９China）[Abstract]Objective：Toobservetheclinicaleffectofvalsartancombinedwithbenazeprilinthetreatmentofdiabeticnephropathy(DN).Methods:78caseswithtype2diabetesalongwithearlynephropathywererandomlydividedinto3groupswhichonewastreatedwithvalsartan80mgdailyanotherwastreatedwithbenazapril10mgdailyandthecombinedtherapygroupwastreatedwithvalsartanandbenazapril.Atthebeginningandtheendoftreatmenttheurinaryalbuminexcretionrate(UAER)in24hoursthemeanarterialbloodpressure(MAP)andrenalfunctionweremeasured.Results：After16weekstreatmentthelevelofUAERdecreasedinallgroups.Moresignificantincombinedgroupcomparedwiththeothertwogroupswithsingledrug.Nosevereadversereactionoccured.Conclusion：CombinationofvalsartanandbenazeprilinthetreatmentofdiabeticnephropathycandecreasebloodpressureavailablysignificantlydecreaseurinaryproteinthenpreventthedevelopmentofDNandimprovethesurvivalsituationofDNpatients.[Keywords]Diabeticnephropathy(DN);Valsartan;Benazapril;Urinaryalbuminexcretionrate(UAER)糖尿病肾病(DN)是糖尿病（DM)常见的微血管并发症之一患者中30%～40%发生糖尿病肾病是糖尿病致死、致残的重要原因之一。糖尿病肾病早期以微量白蛋白尿为特征如果在糖尿病早期能够积极控制蛋白尿则可延迟其进入临床蛋白尿期延缓终末期肾衰竭的发生[1]。我科应用缬沙坦联合贝那普利治疗2型糖尿病（T2DM）早期肾病取得了良好效果现总结报道如下：1资料与方法1.1研究对象2005～2006年在我院住院