目的：比较缬沙坦与卡托普利单独及联合用药治疗糖尿病肾病的临床疗效。方法将120例糖尿病肾病患者按治疗方法的不同分为3组：缬沙坦组（A组）、卡托普利组（B组）和缬沙坦＋卡托普利组（C组），每组40例。3组均采用严格控制饮食，胰岛素控制血糖，不增加机体活动量，并使血糖控制在正常范围内。在此基础上，A组采用缬沙坦胶囊治疗，B组采用卡托普利片治疗，C组采用缬沙坦胶囊联合卡托普利片治疗。观察3组治疗前、治疗6个月后生化指标[尿白蛋白排泄率（UAER）及血总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、肌酐（Scr）、尿素氮（BUN）和空腹血糖（FBG）]、血压（SBP、DBP）及不良反应的情况。结果3组治疗6个月后尿UAER及血TC、TG、LDL-C、Scr、BUN 和 FBG 水平均较治疗前明显降低（均P＜0．05），C 组治疗6个月后尿UAER、SBP水平均较 A 组、B 组下降更明显（均P＜0．05）。3组不良反应发生率比较差异无统计学意义（P＞0．05）。结论缬沙坦与卡托普利对糖尿病肾病均有一定的治疗效果，联合使用效果更佳。%Objective To compare the effects of valsartan,captopril and their combination on diabetic nephropathy.Methods A total of 120 patients with diabetic nephropathy were treated with valsartan capsules(group A,n=40),captopril tablets(group B,n=40)or combined valsartan capsules and captopril tablets(group C,n=40).All patients were given diet control and blood glu-cose control with insulin and reducing activities.Urinary albumin excretion rate (UAER)and blood total cholesterol(TC),triacylglycerol(TG),low density lipoprotein cholesterol(LDL-C),se-rum creatinine(Scr),blood urea nitrogen(BUN),fasting blood glucose(FBG),systolic blood pres-sure(SBP),diastolic blood pressure (DBP)and adverse reactions were observed before and 6 months after treatment.Results The urinary UAER and blood levels of TC,TG,LDL-C,Scr, BUN and FBG significantly decreased 6 months after treatment(P<0.05).In addition,the de-crease in urinary UAER and SBP in group C was more obvious than that in group A or group B (P<0.05).No significant differences in the incidence of adverse reactions were found among the three groups(P>0.05).Conclusion Combined valsartan and captopril treatment is superior to valsartan or captopril alone for diabetic nephropathy.
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