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目的探讨长效钙离子拮抗剂 (左旋氨氯地平 )和血管紧张素转换酶 (ACE)抑制剂 (依那普利 )对老年 2型糖尿病肾病高血压和尿白蛋白的影响。方法将 36例糖尿病肾病患者 (男2 3例 ,女 13例 ,平均年龄 6 3± 7岁 )随机分为三组 :左旋氨氯地平组 (12例 )、依拉普利组 (12例 )及两药联合治疗组 (12 )例。三组在治疗糖尿病的基础上 ,分别服用左旋氨氯地平 2 .5mg、依拉普利 5mg ,清晨口服 ,每日一次 ,如果治疗 2周后血压仍未降至正常 (>140 /90mmHg) ,则左旋氨氯地平增加至 5mg ,依拉普利增加至 10mg ,共用 12周。结果两药单独治疗均可明显降低糖尿病肾病高血压 (P均 <0 .0 1) ,并可减少 2 4h尿白蛋白排出 (P <0 .0 5 )。两药联合治疗降低血压和降低尿蛋白的幅度明显优于单独治疗 (P <0 .0 1)。结论左旋氨氯地平和依拉普利治疗糖尿病肾病所致的高血压均有较好的降低血压和 2 4h尿蛋白的排泄作用。两药联合起协同效应。
Objective To investigate the effects of long-acting calcium ion antagonist (L-amlodipine) and angiotensin converting enzyme (ACE) inhibitor (enalapril) on hypertension and urinary albumin in elderly type 2 diabetic patients. Methods 36 Thirty-six patients with diabetic nephropathy (23 males and 13 females with an average age of 6 3 ± 7 years) were randomly divided into three groups: levamlodipine group (n = 12), enalapril group Cases) and two drugs combined treatment group (12 cases). Three groups on the basis of the treatment of diabetes, were taking levamlodipine 2.5mg, enalapril 5mg, oral once a day, once a day, if the blood pressure after 2 weeks of treatment has not yet dropped to normal (> 140 / 90mmHg) Then levamlodipine increased to 5mg, enalapril increased to 10mg, shared for 12 weeks. Results Both drugs alone significantly reduced diabetic nephropathy (P <0.01) and decreased urinary albumin excretion by 24 h (P <0.05). The combination of the two drugs to reduce blood pressure and reduce the magnitude of urine protein was significantly better than the single treatment (P <0. Conclusion L-amlodipine and enalapril treatment of diabetic nephropathy caused by hypertension are better blood pressure and 24 h urine protein excretion. The two drugs combined synergistic effect.