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目的了解血管紧张素转换酶抑制剂(ACEI)或血管紧张素受体拮抗剂(ARB)及联合用药治疗慢性肾脏病减少、尿蛋白和延缓肾功能衰竭的疗效、安全性及差别。方法将132例慢性肾脏病(慢性肾小球肾炎119例、糖尿病肾病13例)患者分A、B、C三个组,分别用ACEI、ARB及联合治疗,观察尿常规、24 h尿蛋白定量、肾功能、血钾。结果三组患者基本资料(包括年龄、性别、原发病、血压、血肌酐、尿蛋白)比较差异无统计学意义;尿蛋白降幅在50%~75%时用药剂量C组>A组和B组(P<0.01),但A、B组之间差异无统计学意义;平均动脉压、血肌酐和血钾三组比较差异无统计学意义。结论联合用药延缓慢性肾衰进展和减少蛋白尿的疗效强于单一用药。
Objective To investigate the efficacy, safety and differences of angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) and combination therapy in the treatment of chronic kidney disease, urinary protein and delayed renal failure. Methods A total of 132 patients with chronic kidney disease (119 cases of chronic glomerulonephritis and 13 cases of diabetic nephropathy) were divided into three groups: A, B and C, respectively. ACEI, ARB and combination therapy were used to observe urinary routine, , Kidney function, serum potassium. Results There was no significant difference in basic data (including age, sex, primary disease, blood pressure, serum creatinine and urinary protein) in the three groups. When the proteinuria decreased by 50% ~ 75% (P <0.01). However, there was no significant difference between A and B groups. There was no significant difference in mean arterial pressure, serum creatinine and serum potassium among the three groups. Conclusions Combination therapy can delay the progress of chronic renal failure and reduce proteinuria more effective than single drug.