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目的:观察福辛普利联合缬沙坦和辛伐他汀治疗糖尿病肾病的临床疗效。方法:回顾性分析2006年7月至2009年7月在我院明确诊断并治疗的75例糖尿病肾病患者的临床疗效,所有患者均为IV期糖尿病肾病患者,尿白蛋白>300mg/24h。患者按分层随机抽样分为3组,I组:福辛普10-30mg/d;II组:福辛普利5-15mg/d+缬沙坦80-160mg/d;III组:福辛普利5-15mg/d+缬沙坦80-160mg/d+辛伐他汀20mg/d。根据患者血压适当调整各类药物的用量,三组疗程均为6个月,治疗期间观察24h尿白蛋白量、肾功能(血肌酐、血尿素氮)、血脂(总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白)和干咳、恶心、肌痛等不良反应。结果:治疗后III组患者血脂(总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇)等方面均优于I组和II组患者(P<0.05),治疗后III组患者24h尿白蛋白量较I组和II组患者明显降低,差异具有统计学意义(P<0.05);三组患者出现的不良反应差异无统计学意义。结论:福辛普利联合缬沙坦和辛伐他汀治疗糖尿病肾病能有效改善肾功能,改善糖尿病肾病患者脂质代谢,是目前应用于临床较好的方法之一。
Objective: To observe the clinical efficacy of fosinopril combined with valsartan and simvastatin in the treatment of diabetic nephropathy. Methods: The clinical efficacy of 75 patients with diabetic nephropathy diagnosed and treated in our hospital from July 2006 to July 2009 were retrospectively analyzed. All patients were stage IV diabetic nephropathy with urinary albumin> 300mg / 24h. Patients were divided into three groups according to stratified random sampling: group I: fosinopril 10-30mg / d; group II: fosinopril 5-15mg / d + valsartan 80-160mg / d; group III: fosinop Lee 5-15mg / d + valsartan 80-160mg / d + simvastatin 20mg / d. According to the patient’s blood pressure, the dosage of various drugs was appropriately adjusted. The three courses of treatment were all 6 months. The levels of urinary albumin, renal function (serum creatinine, blood urea nitrogen), blood lipid (total cholesterol, triglyceride, low Density lipoprotein, high density lipoprotein) and dry cough, nausea, myalgia and other adverse reactions. Results: The blood lipids (total cholesterol, triglyceride, low density lipoprotein cholesterol and high density lipoprotein cholesterol) in group III were better than those in group I and group II after treatment (P <0.05). After treatment, group III 24h urinary albumin levels were significantly lower than those in group I and group II, the difference was statistically significant (P <0.05); There was no significant difference in adverse reactions between the three groups. CONCLUSION: Fosinopril combined with valsartan and simvastatin can effectively improve renal function and improve lipid metabolism in patients with diabetic nephropathy, which is one of the better clinical methods.