CAJ | 학술논문

目的：探讨厄贝沙坦联合氨氯地平治疗高血压合并糖尿病肾病的治疗效果。方法对2011年3月～2014年3月于余杭区第一人民医院院收治的糖尿病肾病合并高血压的患者120例，随机分为3组，每组40例，根据其给药情况分别为厄贝沙坦组、氨氯地平组、厄贝沙坦联合氨氯地平组。治疗10周后对3组患者的血压、24h尿白蛋白、24h尿蛋白定量和尿β2-微球蛋白等指标进行观察和比较。结果治疗后，A、B两组组总有效率无统计学差异。 C组总有效率（92.5％）显著高于A组（χ2＝6.65，P＜0.05），C组总有效率显著高于B组（χ2＝7.81，P＜0.05）。治疗后，3组患者的血压均下降至正常水平，但是联用组的血压显著低于厄贝沙坦组和氨氯地平组，差异具有统计学意义（ P＜0.05）；治疗后3组患者的尿液检查相关指标亦显著降低，但是联用组的24 h尿白蛋白、24 h尿蛋白定量和尿β2-微球蛋白等均显著低于厄贝沙坦组和氨氯地平组，差异具有统计学意义（ P＜0.05）。3组均无明显不良反应。结论厄贝沙坦联合氨氯地平治疗高血压合并糖尿病肾病相比较单独用药疗效显著。
목적：탐토액패사탄연합안록지평치료고혈압합병당뇨병신병적치료효과。방법대2011년3월～2014년3월우여항구제일인민의원원수치적당뇨병신병합병고혈압적환자120례，수궤분위3조，매조40례，근거기급약정황분별위액패사탄조、안록지평조、액패사탄연합안록지평조。치료10주후대3조환자적혈압、24h뇨백단백、24h뇨단백정량화뇨β2-미구단백등지표진행관찰화비교。결과치료후，A、B량조조총유효솔무통계학차이。 C조총유효솔（92.5％）현저고우A조（χ2＝6.65，P＜0.05），C조총유효솔현저고우B조（χ2＝7.81，P＜0.05）。치료후，3조환자적혈압균하강지정상수평，단시련용조적혈압현저저우액패사탄조화안록지평조，차이구유통계학의의（ P＜0.05）；치료후3조환자적뇨액검사상관지표역현저강저，단시련용조적24 h뇨백단백、24 h뇨단백정량화뇨β2-미구단백등균현저저우액패사탄조화안록지평조，차이구유통계학의의（ P＜0.05）。3조균무명현불량반응。결론액패사탄연합안록지평치료고혈압합병당뇨병신병상비교단독용약료효현저。
Objective To explore the therapeutic efficacy of irbesartan combined amlodipine for the treatment of hypertension and diabetic nephropathy.Methods 120 patients with diabetic nephropathy and hypertension received from March 2011 to March 2014 were randomly divided into three groups according to its administration circumstances ( irbesartan group and amlodipine group, irbesartan and amlodipine groups) , with 40 patients in each group.Blood pressure, 24h urine albumin, 24h urinary protein excretion and urine β2-microglobulin and other indicators of the three groups of patients were observed and compared after 10 weeks of treatment.Results After treatment, the total efficiency of A, B two groups was no significant difference.The total effective rate of group C (92.5%) was significantly higher than that in A group (χ2 =6.65, P<0.05), the total effective rate of group C was significantly higher than that of group B (χ2 =7.81, P<0.05).The blood pressure in patients of three groups were all dropped to normal after treatment, but the one in combination group was significantly lower than the irbesartan group and amlodipine group, the difference was statistically significant (P<0.05).The urine tests related indicators of patients in the three groups were also significantly reduced after treatment , but 24 h urine albumin, 24 h urinary protein excretion and urine β2-microglobulin in combination group were significantly lower than the irbesartan group and amlodipine group, the difference was statistically significant (P<0.05).Three groups were no obvious adverse reactions. Conclusion Irbesartan combined amlodipine for the treatment of hypertension and diabetic nephropathy has significant efficacy compared to single drug.