摘要
目的探讨依普沙坦联合硝苯地平治疗老年2型糖尿病肾病(DN)伴高血压病人的疗效及其对病人生化指标的影响。方法 117例老年2型DN伴高血压病人依据随机数字表法分为对照组(n=59)和观察组(n=58)。2组病人均给予常规治疗,在此基础上,对照组给予硝苯地平治疗,观察组给予依普沙坦联合硝苯地平治疗。比较2组的治疗疗效,治疗前后血压、尿白蛋白排泄率(UAER)、C反应蛋白(CRP)、肾功能水平以及药物不良反应发生率。结果观察组的总有效率(87.93%)显著高于对照组(76.23%),差异有统计学意义(χ2=4.878,P<0.05)。治疗前,2组间舒张压(DBP)、收缩压(SBP)、UAER、CRP、肌酐(SCr)、尿素氮(BUN)及内生肌酐清除率(Ccr)水平比较,差异无统计学意义(P>0.05);治疗后,2组DBP、SBP、UAER、CRP、SCr及BUN水平均显著低于治疗前,且观察组治疗后水平显著低于对照组,差异有统计学意义(P<0.05);治疗后观察组Ccr水平显著高于治疗前,差异有统计学意义(P<0.05)。2组药物不良反应发生率比较,差异无统计学意义(χ2=0.521,P>0.05),且均无严重药物不良反应发生。结论依普沙坦联合硝苯地平治疗老年2型DN伴高血压的疗效显著,可有效降低病人血压、UAER及CRP水平,改善肾功能,安全性高,具有重要临床价值。
Objective To investigate the effect of nifedipine in the treatment of elderly patients with type 2 diabetic nephropathy（ DN） combined with hypertension in the elderly patiants,and its influence on biochemical index. Methods According to random number table,117 elderly patients with type 2 DN combined with hypertension were divided into control group（ n = 59） and observation group（ n = 58）. Patients in two groups were given conventional treatment,and the control group was treated with nifedipine additionally,and the observation group was treated with eprosartan combined with nifedipine on the basis of control group. The efficacy of two groups was evaluated and compared. The diastolic blood pressure（ DBP）,systolic blood pressure（ SBP）,urinary albumin excretion rate（ UAER）,C-rective protein（ CRP）,the level of renal function,and the incidence of adverse drug reactions before and after treatment between two groups were compared. Results The total effective rate of the observation group（ 87. 93%） was significantly higher than that of the control group（ 76. 23%）（ χ2=4. 878,P〈0. 05）. Before treatment,there were no statistical significance in the levels of DBP,SBP,UAER,CRP,SCr and BUN between two groups（ P〈0. 05）. After treatment,the levels of DBP,SBP,UAER,CRP,SCr,BUN and Ccr in two groups were significantly lower than those before treatment,and the levels of the observation group were significantly lower those that in the control group（ P〈0. 05）. After treatment,the level of Ccr in the observation group was significantly higher than that before treatment（ P〈0. 05）. There was no significant difference in the incidence of adverse drug reactions between two groups（ χ2= 0. 521,P〈0. 05）,and no serious adverse drug reactions occured. Conclusions The curative effect of eprosartan combined with nifedipine in the treatment of elderly patients with type 2 DN combined with hypertension is significant,which can effectively reduce the levels of blood pressure,UAER and CRP,and improve renal function. It has high safety and important clinical value.
作者
王科新
王忠志
敖云菊
李福勇
WANG Ke-xin;WANG Zhong-zhi;AO Yun- ju;LI Fu-yong.(Department of Geriatrics, Chongqing Jiangjin District Hospital of Traditional Chinese Medicine, Chongqing 402260, Chin)
出处
《实用老年医学》
CAS
2018年第6期539-542,共4页
Practical Geriatrics
关键词
糖尿病肾病
高血压
依普沙坦
硝苯地平
疗效
生化指标
diabetic nephropathy
hypertension
eprosartan
nifedipine
efficacy
biochemical markers
