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目的观察依那普利与氯沙坦联用治疗高血压并发2型糖尿病患者微量白蛋白尿的临床疗效。方法将60例高血压并发2型糖尿病伴微量白蛋白尿的患者随机分为两组,分别使用氯沙坦、依那普利两药联用为治疗组(n=30),单用依那普利为观察组(n=30),疗程16周。观察两组治疗前后各组患者的血压,治疗前后尿白蛋白排泄率(UAER)。结果两组血压均较治疗前明显降低(P<0.05),但治疗后两组血压间比较,差异无统计学意义(P>005);两组患者经治疗16周后平均UAER水平分别由(108±30)μg/min、(114±31)μg/min降至(74±28)μg/min、(92±26)μg/min(均P<0.01),治疗组降低程度更为显著(P<0.05)。结论氯沙坦联合依那普利治疗在有效降压的同时,能改善高血压并发2型糖尿病患者早期肾损害,提示有早期肾损害患者应尽早联合降压治疗。
Objective To observe the clinical efficacy of enalaprol combined with losartan in the treatment of microalbuminuria in type 2 diabetic patients with hypertension. Methods Sixty patients with hypertension complicated with type 2 diabetes mellitus and microalbuminuria were randomly divided into two groups. The two groups were treated with losartan and enalapril respectively (n = 30) Puli for the observation group (n = 30), treatment of 16 weeks. The blood pressure, urinary albumin excretion rate (UAER) before and after treatment were observed in two groups before and after treatment. Results The blood pressure of the two groups was significantly lower than that before treatment (P <0.05), but there was no significant difference in blood pressure between the two groups after treatment (P> 005). The mean UAER levels of the two groups after treatment for 16 weeks were respectively 108 ± 30 μg / min and 114 ± 31 μg / min to 74 ± 28 μg / min and 92 ± 26 μg / min respectively (all P <0.01). The reduction in the treatment group was more significant P <0.05). Conclusion Losartan combined with enalapril treatment can reduce blood pressure and improve hypertension in patients with type 2 diabetes early renal damage, suggesting that patients with early renal damage should be combined with antihypertensive therapy.