CAJ | 학술논문

目的：观察贝那普利、厄贝沙坦联合阿托伐他汀在治疗早期糖尿病肾病患者中的疗效。方法选取我科住院的糖尿病肾病患者85例，随机分成3组，A组（贝那普利组10mg/d）27例，B组（贝那普利10mg/d +厄贝沙坦组150 mg/d）23例，C组（贝那普利10mg/d +厄贝沙坦150 mg/d +阿托伐他汀组10 mg/d）35例，全部病例连续治疗12周后，观察患者治疗前后血压、血清胆固醇（TC）、甘油三酯（TG）、血清内生肌酐清除率（Ccr）及24h尿微量白蛋白定量以及治疗后三组间上述各项指标。结果3组患者治疗后收缩压、舒张压及平均动脉压(MAP)较治疗前均有明显降低，差异有统计学意义(P<0．01)， B组、C组治疗后收缩压、舒张压和MAP与A组比较有明显降低（P<0．05）。C组治疗后TC、TG较治疗前有显著下降（p＜0.05），3组患者治疗后血清内生肌酐清除率（C c r）及24h尿微量白蛋白定量均较治疗前有明显改善（p＜0.05），其中C组治疗后血清内生肌酐清除率（C c r）及24h尿白微量蛋白定量较其他2组也有显著差异（p＜0.05）。结论贝那普利、厄贝沙坦和阿托伐他汀联合应用可明显降低血压、血脂及显著改善血清内生肌酐清除率和尿蛋白排泄率。
목적：관찰패나보리、액패사탄연합아탁벌타정재치료조기당뇨병신병환자중적료효。방법선취아과주원적당뇨병신병환자85례，수궤분성3조，A조（패나보리조10mg/d）27례，B조（패나보리10mg/d +액패사탄조150 mg/d）23례，C조（패나보리10mg/d +액패사탄150 mg/d +아탁벌타정조10 mg/d）35례，전부병례련속치료12주후，관찰환자치료전후혈압、혈청담고순（TC）、감유삼지（TG）、혈청내생기항청제솔（Ccr）급24h뇨미량백단백정량이급치료후삼조간상술각항지표。결과3조환자치료후수축압、서장압급평균동맥압(MAP)교치료전균유명현강저，차이유통계학의의(P<0．01)， B조、C조치료후수축압、서장압화MAP여A조비교유명현강저（P<0．05）。C조치료후TC、TG교치료전유현저하강（p＜0.05），3조환자치료후혈청내생기항청제솔（C c r）급24h뇨미량백단백정량균교치료전유명현개선（p＜0.05），기중C조치료후혈청내생기항청제솔（C c r）급24h뇨백미량단백정량교기타2조야유현저차이（p＜0.05）。결론패나보리、액패사탄화아탁벌타정연합응용가명현강저혈압、혈지급현저개선혈청내생기항청제솔화뇨단백배설솔。
Objective To investigate the clinical efficacy of Benazepril combined with Irbesartan and Atorvastatin in the treatment of early diabetic nephropathy(DN). Methods 85 patients of diabetic nephropathy(DN) in our hospital were randomly divided into three groups: group A (Benazepril 10mg/d n=27), group B (Benazepril 10mg/d+ Irbesartan 150 mg/d n=23), group C (Benazepril 10mg/d+ Irbesartan 150 mg/d+ Atorvastatin 10 mg/d n=35). BP,TC, TG, the level of Ccr and 24h urinary microalbumin were statistical y analyzed before and after 12 weeks treatment. Results Systolic blood pressure(SBP) 、diastolic blood pressure(DBP) and mean arterial blood pressure(MAP)after treatment in the three groups were significantly lower than those before treatment(p<0.05). SBP, DBP and MAP in group B and group C after treatment were lower than those in group A(p<0.05). After 12 weeks treatment, The levels of TC,TG in group C were decreased significantly(p<0.05). The levels of Ccr and 24h urinary microalbumin in the three groups were significantly improved after treatment than those before treatment(p<0.05).Among the three groups, the levels of Ccr and 24h urinary microalbumin in the group C were of statistical difference compared with those in the other two groups. Conclusion Benazepril combined with Irbesartan and Atorvastatin can decreased the blood pressure、blood lipids significantly and can significantly improve the levels of Ccr and 24h urinary microalbumin of patients with DN.