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目的 评价血管紧张素Ⅰ转换酶抑制剂 (ACEI)和血管紧张素Ⅱ受体 1拮抗剂 (ATla)联合治疗糖尿病肾病 (DN)伴高血压的临床价值 .方法 观察两组糖尿病肾病伴高血压患者 ,比较联合应用氯沙坦和ACEI(治疗组 )与单独使用大剂量ACEI(对照组 )在降低血压和尿白蛋白排泄 (UAE)、影响糖代谢和肾功能以及不良反应等方面的差异 .结果 治疗 8周后两组尿蛋白、UAE、血压均明显下降 ,治疗组下降幅度大于对照组 ,副作用出现率低 (P <0 .0 5 ) ,控制血糖所需的胰岛素剂量、血肌酐等变化和组间差异不显著 (P >0 .0 5 ) .结论 ATla和ACEI是治疗DN的有效药物 ,联合应用更有利于保护肾脏 ,可能是临床治疗方案的一种选择 .
Objective To evaluate the clinical value of combination of angiotensin Ⅰ converting enzyme inhibitor (ACEI) and angiotensin Ⅱ receptor 1 antagonist (ATla) in the treatment of diabetic nephropathy (DN) with hypertension.Methods Two groups of patients with diabetic nephropathy , And compared the difference between losartan and ACEI (treatment group) and high dose ACEI alone (control group) in lowering blood pressure and urinary albumin excretion (UAE), influencing glucose metabolism, renal function and adverse reaction.Results After 8 weeks of treatment, urinary protein, UAE and blood pressure decreased obviously in both groups, and the decreasing rate in the treatment group was greater than that in the control group, the incidence of side effects was low (P <0.05), the dosage of insulin needed to control blood sugar and serum creatinine There was no significant difference between the two groups (P> 0.05) .Conclusion ATla and ACEI are effective drugs for the treatment of DN, and combined application is more conducive to the protection of the kidneys, which may be an option for clinical treatment.