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目的进一步探讨氯沙坦、辛伐他汀、福辛普利三药联合对慢性肾病的治疗效果,完善院内药物使用制度和方式。方法 84例慢性肾病者,采用随机方式分为对比组和治疗组,每组42例。对比组中患者口服福辛普利10 mg/d以及氯沙坦50 mg/d;治疗组口服福辛普利10 mg/d、氯沙坦50 mg/d以及辛伐他汀20 mg/d。两组患者治疗期限均为6个月,每3个月对两组患者进行1次舒张压、收缩压、尿蛋白、血肌酐测量。用药期间需进行降压治疗以及饮食治疗,严格监控治疗行为。结果治疗组:尿蛋白初测值(709.0±140.0)mg/24 h,尿蛋白末测值(381.0±113.0)mg/24 h;血肌酐初测值(97.3±14.2)μmol/min,血肌酐末测值(90.7±11.2)μmol/min。对比组:尿蛋白初测值(711.0±128.0)mg/24 h,尿蛋白末测值(450.0±107.0)mg/24 h;血肌酐初测值(96.2±11.7)μmol/min,血肌酐末测值(99.2±12.4)μmol/min。对比两组患者治疗结果,尿蛋白与血肌酐变化结果差异具有统计学意义(P<0.05);但血压值变化情况差异无统计学意义(P>0.05)。结论非糖尿病慢性肾病者,较传统福辛普利联合氯沙坦的药物治疗方式,氯沙坦、福辛普利联合辛伐他汀(或其他他汀类调脂药物)具有更理想的治疗效果,在血压控制结果相同的条件下,后者对尿蛋白、血肌酐的控制效果更理想,且无不良反应和副作用,可作为临床常规治疗方式使用。
Objective To further explore the therapeutic effect of losartan, simvastatin and fosinopril in the treatment of chronic kidney disease and improve the system and method of drug use in the hospital. Methods Eighty-four patients with chronic kidney disease were randomly divided into control group and treatment group, 42 cases in each group. The patients in the control group were treated with fosinopril 10 mg / d and losartan 50 mg / d. The patients in the treatment group were given fosinopril 10 mg / d, losartan 50 mg / d and simvastatin 20 mg / d orally. The duration of treatment in both groups was 6 months. Diastolic blood pressure, systolic blood pressure, urinary protein and serum creatinine were measured in two groups every three months. During treatment need to be antihypertensive treatment and diet therapy, strict monitoring of treatment behavior. Results In the treatment group, the initial urinary protein (709.0 ± 140.0) mg / 24 h, the final urinary protein (381.0 ± 113.0) mg / 24 h, the initial serum creatinine (97.3 ± 14.2) μmol / Final measurement (90.7 ± 11.2) μmol / min. In the control group, the initial urinary protein level was (711.0 ± 128.0) mg / 24 h, the final urinary protein level was (450.0 ± 107.0) mg / 24 h, the initial serum creatinine was 96.2 ± 11.7 μmol / min, Measured value (99.2 ± 12.4) μmol / min. Comparing the treatment outcome of the two groups, the difference of urinary protein and serum creatinine had statistical significance (P <0.05), but there was no significant difference in the changes of blood pressure (P> 0.05). Conclusion Compared with traditional fosinopril combined with losartan, losartan, fosinopril and simvastatin (or other statin lipid-lowering drugs) in patients with non-diabetic chronic kidney disease have more satisfactory therapeutic effect, In the same blood pressure control conditions, the latter of urinary protein, serum creatinine control effect is more ideal, and no adverse reactions and side effects, can be used as a routine clinical treatment.