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目的:探讨左旋氨氯地平联合氯沙坦治疗2型糖尿病肾病(T2DN)合并高血压的疗效及对血压和肾功能的影响。方法:采用随机数字表法将2010年1月至2013年1月本院门诊及住院部收治的260例T2DN合并高血压患者分为实验组和对照组,每组患者130例,实验组给予左旋氨氯地平和氯沙坦口服联合治疗,对照组仅给予左旋氨氯地平口服治疗,对比两组疗效,并观察两组治疗前后的收缩压(SBP)和舒张压(DBP)、血肌酐(Scr)水平、尿微量白蛋白(UMALB)/尿肌酐(Ucr)水平和24 h UMALB水平。结果:实验组的总有效率90.77%显著高于对照组的78.46%(P<0.05);治疗后两组SBP、DBP、脉压差、SCr、UMALB/Ucr及24h UMALB水平均有显著下降(P<0.05),且实验组均显著低于对照组(P<0.05)。结论:左旋氨氯地平联合氯沙坦不仅可有效降低T2DN合并高血压患者血压,还可有效减少尿液中蛋白的排放,保护患者的肾脏功能,疗效显著,值得推广。
Objective: To investigate the effect of levamlodipine combined with losartan on type 2 diabetic nephropathy (T2DN) with hypertension and its effect on blood pressure and renal function. Methods: A total of 260 T2DM patients with hypertension complicated with hypertension and hypertension admitted to outpatient department and inpatient department of our hospital from January 2010 to January 2013 were randomly divided into experimental group and control group, with 130 patients in each group. Amlodipine and losartan combined oral treatment, the control group was given only oral levamlodipine treatment, the two groups were compared and observed systolic blood pressure (SBP) and diastolic blood pressure (DBP), serum creatinine (Scr ) Levels, urinary albumin (UMALB) / urinary creatinine (Ucr) levels and 24 h UMALB levels. Results: The total effective rate (90.77%) in the experimental group was significantly higher than that in the control group (78.46%, P <0.05). SBP, DBP, pulse pressure difference, SCr, UMALB / Ucr and 24h UMALB were significantly decreased P <0.05), and the experimental group were significantly lower than the control group (P <0.05). Conclusion: L-amlodipine combined with losartan can not only effectively reduce the blood pressure in patients with T2DM complicated with hypertension, but also reduce the protein excretion in urine effectively and protect the renal function of patients. The therapeutic effect is worthy of promotion.