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目的观察氨氯地平联合贝那普利治疗糖尿病肾病合并高血压患者的临床疗效。方法选择在医院内分泌科接受治疗的2型糖尿病早期肾病合并高血压患者150例。按治疗方案不同分为3组,A组患者给予氨氯地平治疗;B组患者给予贝那普利治疗;C组患者给予氨氯地平联合贝那普利治疗。疗程均为10周。治疗后,观察2组患者治疗前后尿微量白蛋白(mAlb)、24h尿蛋白、血肌酐(Cr)、血尿素氮(BUN)和血压水平。结果治疗结束后,3组患者的mAlb、24h尿蛋白、Cr水平均低于治疗前,差异有统计学意义(P<0.05)。C组治疗后mAlb、24 h尿蛋白水平低于A、B组治疗后,差异有统计学意义(P<0.05)。3组治疗前后BUN水平比较差异无统计学意义(P>0.05)。治疗后,3组SBP、DBP和脉压均降低,且C组降低优于A、B组,差异均有统计学意义(P<0.05)。A、B两组患者中均无患者增加药物剂量,服药后A组患者出现腹痛、水肿、头痛、失眠患者2例(3.8%),B组患者出现干咳患者4例(8.2%),C组患者出现眩晕或面色潮红3例(6.2%)。出现药物不良反应患者均在耐受程度内,无患者退出试验。3组不良反应发生率比较差异无统计学意义(P>0.05)。结论氨氯地平联合贝那普利治疗糖尿病肾病合并高血压的降压作用及改善蛋白尿作用较单用氨氯地平或贝那普利更好。
Objective To observe the clinical efficacy of amlodipine and benazepril in the treatment of diabetic nephropathy with hypertension. Methods 150 patients with type 2 diabetes mellitus with early nephropathy and hypertension undergoing hospital endocrinology were selected. According to different treatment options are divided into 3 groups, A group of patients given amlodipine treatment; B group benazepril treatment; C group of patients given amlodipine benazepril treatment. Treatment are 10 weeks. After treatment, the urinary albumin (mAlb), 24h urinary protein, serum creatinine (Cr), blood urea nitrogen (BUN) and blood pressure were observed before and after treatment in two groups. Results After the treatment, the levels of mAlb, 24h urinary protein and Cr in the three groups were all lower than those before treatment (P <0.05). C group after treatment mAlb, 24 h urinary protein levels lower than A, B group after treatment, the difference was statistically significant (P <0.05). There was no significant difference in BUN level between the three groups before and after treatment (P> 0.05). After treatment, SBP, DBP and pulse pressure decreased in all three groups, and the reduction in group C was better than that in group A and B (P <0.05). None of patients in group A and B had an increase in drug dose. Two patients (3.8%) developed abdominal pain, edema, headache and insomnia in group A, and four patients (8.2%) in group B received dry cough. Patients in group C The patient developed dizziness or flushing in 3 cases (6.2%). Adverse drug reactions occurred in patients were within tolerance, no patient out of the test. The incidence of adverse reactions in the three groups showed no significant difference (P> 0.05). Conclusion Amlodipine combined with benazepril treatment of diabetic nephropathy with hypertension and antihypertensive effect of proteinuria than single with amlodipine or benazepril better.