阿托伐他汀联合替米沙坦防治早期糖尿病肾病的疗效观察(1)
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[摘要] 目的：观察阿托伐他汀联合替米沙坦防治早期糖尿病肾病的疗效。方法：将70例纳入观察的患者随机分为治疗组和对照组各35例，治疗组给予阿托伐他汀和替米沙坦，对照组仅给予阿托伐他汀，连续治疗3个月后检测治疗前后UAE、SCr、BUN、CysC，统计DN分期情况，并记录不良反应发生情况。结果：治疗组疗效优于对照组，差异具有统计学意义(P<0.05)，两组患者治疗后UAE、SCr、BUN、CysC均有明显下降，差异均具有统计学意义(P<0.05)，治疗后治疗组的UAE、SCr、BUN、CysC均低于对照组，差异均具有统计学意义(P<0.05)。结论：阿托伐他汀联合替米沙坦防治早期糖尿病肾病疗效确切，比单纯应用阿托伐他汀好。
[关键词] 糖尿病肾病；阿托伐他汀；替米沙坦；联合治疗
[中图分类号] R587.2 [文献标识码] A [文章编号] 1674-4721(2012)01(b)-055-02
Therapeutic efficacy of atorvastatin combined with telmisartan in the treatment of early diabetic nephropathy
WU Zhijian
Traditional Chinese Medicine Hospital of Taojiang County in Hunan Province, Taojiang 413400, China
[Abstract] Objective: To observe the therapeutic efficacy of telmisartan combined with atorvastatin in the treatment of early diabetic nephropathy. Methods: Seventy cases were randomly assigned to treatment group and control group. The treatment group was given atorvastatin and telmisartan, and the control group was given atorvastatin alone. UAE, SCr, BUN, CysC and DN staging before and after 3 months treatment were analyzed and adverse events were recorded. Results: The treatment outcome was significantly better in the treatment group than that in the control group (P<0.05). UAE, SCr, BUN and CysC were significantly reduced in both groups after treatment (P<0.05), and were significantly lower in the treatment group than those in the control group (P<0.05). Conclusion: Atorvastatin combined with telmisartan is effective in the prevention and treatment of early diabetic nephropathy and is more effective than atorvastatin applied alone.
[Key words] Diabetic nephropathy; Atorvastatin; Telmisartan; Combined therapy
糖尿病肾病(diabetic nephropathy，DN)是糖尿病最常见和最严重的慢性并发症之一，也是糖尿病患者的主要死亡原因之一，已成为肾功能衰竭的首位病因，本病以进行性肾脏纤维化为特征，常在5～10年发展至终末期肾衰竭，临床治疗相当辣手，因此早期防治越来越被众多临床医师关注[1]。近年来有报道称他汀类药物和血管紧张素转换酶抑制剂等对糖尿病肾病的发生发展有防治作用，为证实其临床疗效，笔者在临床中做了相关研究，现报道如下：
1 资料与方法
1.1 诊断标准
2009年1月～2011年6月本院收治的早期DN患者83例，其中，男39例，女44例，年龄42～77岁，病程3～27年，所有患者均符合1999年WHO糖尿病诊断标准，且同时符合2007年KDOQI糖尿病肾病指南诊断标准[2]，按DN分期均属于Ⅲ期(糖尿病肾病早期)。
1.2 一般资料
排除最近1个月内服用ARB类降压药或影响血脂的药物者，原发性肾脏病、大血管动脉粥样硬化、肿瘤、甲状腺疾病、糖尿病急性并发症和急性感染等。最后纳入观察患者70例，按纳入观察先后顺序编号，采用SPSS 18.0产生的随机数字表随机分为治疗组和对照组各35例 ......
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