贝那普利联合缬沙坦治疗早期糖尿病肾病的效果与安全性分析

摘要

目的 探讨治疗早期糖尿病肾病(EDN)的有效方案.方法 将2009年3月～2012年5月长沙市第一医院肾内科收治的180例EDN患者随机分为A、B、C三组,所有患者均接受降血糖治疗,在此基础上,A组(60例)接受贝那普利治疗,B组(60例)接受缬沙坦治疗,C组(60例)接受贝那普利联合缬沙坦治疗.治疗20周后对比分析三组患者的疗效与不良反应发生率.结果 治疗前,三组患者平均动脉压(MAP)、尿白蛋白排泄率(UAER)、尿β2微球蛋白(β2-MG)、尿转化生长因子β(TGF-β)、血清胱抑素C(Cys C)比较,差异无统计学意义(P ＞ 0.05).治疗后,三组患者MAP、UAER、β2-MG、TGF-β、Cys C均显著下降(P ＜ 0.05),C组患者上述指标均显著低于A组与B组(P ＜ 0.05).三组患者不良反应发生率比较差异无统计学意义(P ＞ 0.05).结论 贝那普利联合缬沙坦治疗EDN具有改善肾功能、耐受性好等优点.%Objective To investigate the effective program for early diabetic nephropathy (EDN).Methods 180 cases of EDN admitted into the First Hospital of Changsha City from March 2009 to May 2012 were divided into group A (60 cases), group B (60 cases) and group C (60 cases), and all patients were given hypoglycemic therapy.Moreover, group A, group B and group C received Benazepril, Valsartan, Benazepril combined with Valsartan, respectively.The therapeutic efficacy and incidence rate of adverse reactions were compared among the three groups after treatment for 20 weeks.Results Before treatment, there were no significant differences in the mean arterial pressure (MAP), urinary albumin excretion rate (UAER), urinary β2-microglobulin (β2-MG), urinary transforming growth factor-β(TGF-β) and serum cystatin C (Cys C) among the three groups (P > 0.05).After treatment, the MAP, UAER, β2-MG, TGF-β and Cys C of the three groups decreased significantly (P < 0.05), and these above indexes of the group C were significantly lower than those of the group A and the group B respectively (P < 0.05).There were no significant differences in the incidence of adverse reactions among the three groups (P > 0.05).Conclusion Benazepril combined with Valsartan in the treatment of EDN shows some advantages such as improving renal function and having good tolerance.