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目的探讨硝苯地平联合厄贝沙坦治疗老年2型糖尿病肾病合并高血压的临床效果。方法选取2012年5月-2013年12月收治的2型糖尿病肾病合并高血压老年患者140例,随机分为对照组和治疗组各70例,对照组给予硝苯地平,10 mg/次,3次/d,观察组在此基础上给予厄贝沙坦,150 mg/次,1次/d,两组均治疗4个月;比较两组近期疗效,治疗前后收缩压、舒张压、糖化血红蛋白,血尿素氮、血肌酐及尿蛋白排泄率。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果治疗组近期总有效率94.29%明显优于对照组的71.43%,比较差异有统计学意义(P<0.05)。治疗组治疗后收缩压和舒张压分别为(124.77±28.63)、(81.72±9.36)mm Hg(1 mm Hg=0.133 k Pa)均优于对照组的(138.25±36.94)、(94.39±13.82)mm Hg,比较差异均有统计学意义(均P<0.05)。治疗组治疗后尿蛋白排泄率为(104.27±13.19)μg/min低于对照组的(128.63±26.65)μg/min,比较差异均有统计学意义(均P<0.05)。结论硝苯地平与厄贝沙坦联用于老年2型糖尿病肾病合并高血压治疗在提高血压控制效果、改善尿蛋白排泄水平方面具有优势,值得推广。
Objective To investigate the clinical effect of nifedipine combined with irbesartan in the treatment of elderly type 2 diabetic nephropathy with hypertension. Methods Forty elderly patients with type 2 diabetic nephropathy with hypertension were selected from May 2012 to December 2013. They were randomly divided into control group and treatment group, 70 cases in each group. The control group was given nifedipine 10 mg / Times / d, the observation group was given irbesartan, 150 mg / time, once a day, both groups were treated for 4 months; the two groups were compared the short-term curative effect, before and after treatment systolic blood pressure, diastolic blood pressure, glycosylated hemoglobin , Blood urea nitrogen, serum creatinine and urinary protein excretion rate. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The total effective rate in the treatment group was 94.29%, which was significantly higher than that in the control group (71.43%), the difference was statistically significant (P <0.05). The systolic and diastolic blood pressure in the treatment group were (124.77 ± 28.63) and (81.72 ± 9.36) mm Hg (1 mm Hg = 0.133 kPa) respectively, which were significantly higher than those in the control group (138.25 ± 36.94 and 94.39 ± 13.82, respectively) mm Hg, the difference was statistically significant (all P <0.05). The urinary protein excretion rate of the treatment group after treatment was (104.27 ± 13.19) μg / min lower than that of the control group (128.63 ± 26.65) μg / min, with statistical significance (all P <0.05). Conclusion The combination of nifedipine and irbesartan in elderly patients with type 2 diabetic nephropathy complicated with hypertension has advantages in enhancing blood pressure control and improving urinary protein excretion, which is worthy of promotion.