目的 觀察羥苯磺酸鈣聯(lián)合氯沙坦治療老年2型糖尿病腎病合并高血壓的臨床療效。方法 選取2012年11月—2015年3月鄖陽(yáng)醫(yī)學(xué)院堰橋醫(yī)院腎病內(nèi)科收治的老年2型糖尿病腎病合并高血壓患者115例,隨機(jī)分為對(duì)照組(n=57)和治療組(n=58)。對(duì)照組患者口服氯沙坦鉀片50 mg/次,1次/d;治療組患者在對(duì)照組治療基礎(chǔ)上口服羥苯磺酸鈣膠囊,0.5 g/次,3次/d。兩組患者均連續(xù)治療12周。觀察兩組的臨床療效,同時(shí)比較兩組治療前后收縮壓(SBP)、舒張壓(DBP)、平均動(dòng)脈壓(MAP)、血糖、尿微量蛋白、24 h尿蛋白排泄率(UAER)、血肌酐(Scr)、血尿素氮(BUN)的變化情況。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為77.19%、91.38%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者SBP、DBP、MAP、尿微量蛋白、UAER較治療前均顯著降低,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)的改善程度優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后兩組Scr、BUN均顯著下降,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P<0.05),但治療后兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 羥苯磺酸鈣聯(lián)合氯沙坦治療老年2型糖尿病腎病合并高血壓具有較好的臨床療效,可顯著改善患者的腎功能,降低尿微量蛋白和血壓,且安全性好,具有一定的臨床推廣和應(yīng)用價(jià)值。

Objective To observe the clinical effects of calcium dobsilate combined with losartan in treatment of elderly type 2 diabetic nephropathy with hypertension. Methods Patients (115 cases) with elderly type 2 diabetic nephropathy with hypertension in Department of Kidney Disease Internal Medicine of Yanqiao Hospital of Yunyang Medical College from November 2012 to March 2015 were randomly divided into control (n = 57) and treatment groups (n = 58). The patients in the control group were po administered with Losartan Potassium Tablets, 50 mg/time, once daily. The patients in the treatment group were po administered with Calcium Dobsilate Capsules on the basis of the control group, 0.5 g/time, three times daily. The patients in two groups were treated for 12 weeks. After treatment, the clinical efficacies were evaluated, and SBP, DBP, MAP, blood sugar, urine micro protein, UAER, Scr, and BUN before and after treatment in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 77.19% and 91.38%, respectively, and there were differences between two groups (P< 0.05). After treatment, SBP, DBP, MAP, urine micro protein, and UAER in two groups were significantly decreased, and the difference was statistically significant in the same group (P< 0.05). After treatment, those observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P< 0.05). Scr and BUN in two groups were significantly decreased, and the difference was statistically significant in the same group (P< 0.05). But there was no statistically significant difference between two groups after treatment. Conclusion Calcium dobsilate combined with losartan has clinical curative effect in treatment of elderly type 2 diabetic nephropathy with hypertension, and can significantly improve the kidney function, also can decrease the urine micro protein and blood pressure, which has a certain clinical application value.