福辛普利与辛伐他汀单用或联合治疗糖尿病肾病疗效观察

摘要

目的 研究福辛普利与辛伐他汀单用或联合治疗对糖尿病肾病的肾保护作用.方法 90例糖尿病肾病患者随机单盲分为3组:福辛普利组30例,给予福辛普利10mg,口服,1次/d;辛伐他汀组30例,给予辛伐他汀20mg,口服,1 次/d;联合用药组30例,给予辛伐他汀与福辛普利,口服,用法同前2组.疗程均为24周,观察3组治疗前、后的尿白蛋白排泄率、内生肌酐清除率、血脂、血压等指标.结果 治疗后,3组尿白蛋白排泄率与尿蛋白均降低,血清白蛋白升高(P＜0.01);联合用药组尿白蛋白排泄率降低幅度大于福辛普利组与辛伐他汀组,尿蛋白降低与血清白蛋白增长幅度联合用药组大于其他2组(P＜0.01,P＜0.05);3组内生肌酐清除率与空腹血糖均下降,差异无统计学意义(P＞0.05);3组血脂和血压降低均有所改善(P＜0.01),联合用药组血脂改善程度优于其他2组(P＜0.01,P＜0.05).结论 福辛普利与辛伐他汀联用治疗糖尿病肾病,对肾保护有协同作用.%Objective To assess the lenal protective effect of simvastatin and fosinopril used alone or in combination for treating diabetic nephropathy.Methods Ninety patients were randomly divided into three groups:30 patients of fosinopril group were treated with fosinopril 10 mg;30 patients of simvastatin group were treated with simvastatin 20 mg;30 patients in combination therapy group were treated with simvastation 20 mg and fosinopril 10 mg.All patients in each group received the correlative therapy for 24 weeks.The urinary albumin excretion rate (UAER),serum albumin(Alb),creatinine clearance(Ccr),serum creatinine(Scr),blood lipid and blood pressure were observed and recorded before and after treatment.Results After treatment,UAER,urine protein(UPT) decreased and the Alb increased in all three groups(P＜0.01).But the UAER decreased in combination therapy group more than those in fosinopril group and simvastatin group(P＜0.01).Reduction of UPT and Alb in combination therapy group Was more than those in other two groups(P＜0.01,P＜0.05).The Ccr and fasting blood glucose decreased in all groups but showed no significant difference(P＞0.05).The blood lipid and pressure increased in all three groups(P＜0.01),especially in combination therapy group.Conclusion Simvastatin and fosinopril in combination therapy is superior to monotherapy in the treatment of diabetic nephropathy.