2017 年第 12 期 第 12 卷

缬沙坦胶囊和厄贝沙坦片治疗糖尿病肾病合并高血压患者的临床效果

作者：李冠瑾

英文作者：

单位：100062北京市普仁医院药剂科

英文单位：

关键词：糖尿病肾病；高血压；厄贝沙坦；缬沙坦

英文关键词：

• 摘要：

• 目的    比较缬沙坦胶囊和厄贝沙坦片治疗糖尿病肾病（DN）合并高血压患者的临床效果。方法    选择2016年3月至2017年3月于北京市普仁医院确诊并接受治疗的DN合并高血压患者162例。根据随机数字表法，将所有患者分为观察组和对照组，各81例。2组患者均平行接受常规基础治疗，在此基础上，对照组给予口服缬沙坦胶囊，观察组给予口服厄贝沙坦片。2组患者均口服3个疗程，每个疗程12周。结果    观察组治疗6、9个月后收缩压和尿微量白蛋白水平均明显低于治疗前［（130±11）、（129±13）mmHg(1 mmHg=0.133 kPa)比（163±7）mmHg； 26（18，62）、13（7，31）mg/L比47（31，98）mg/L］，差异均有统计学意义（均P＜0.05）；对照组治疗6、9个月后尿微量白蛋白水平明显低于治疗前［33（19，49）、18（7，33）mg/L比 52（41，119）mg/L］，差异均有统计学意义（均P＜0.05）；观察组治疗前和治疗3、6、9个月后血压和尿微量白蛋白水平与对照组比较，差异均无统计学意义（均P＞0.05）。2组患者治疗前后总胆固醇、三酰甘油、血肌酐和糖化血红蛋白水平比较，差异均无统计学意义（均P＞0.05）。观察组治疗总有效率明显高于对照组［92.6%(75/81)比61.7%（50/81）］，差异有统计学意义（P=0.016）。2组患者均未出现严重不良反应,安全性和耐受性良好。结论    厄贝沙坦和缬沙坦均能有效降低DN合并高血压患者的尿微量白蛋白水平，均具有较好安全性和耐受性，而厄贝沙坦在降低收缩压水平方面优于缬沙坦。

• Clinical effects of valsartan and irbesartan on diabetic nephropathy with hypertension

  Li Guanjin

  Department of Pharmacy, Beijing Puren Hospital, Beijing 100062, China, Email: liguanjintg@163.com

  【Abstract】Objective    To compare the effects of valsartan and irbesartan on diabetic nephropathy（DN） with hypertension. Methods    Totally 162 patients with DN accompanied by hypertension from March 2016 to March 2017 in Beijing Puren Hospital were randomly divided into observation group and control group, with 81 cases in each group. On the basis of conventional basic treatment, the control group took valsartan capsules and the observation group took irbesartan tablets for 3 courses（1 course＝12 weeks）.ResultsSystolic blood pressure and urinary microalbumin level significantly decreased 6, 9 months after treatment compared to those before treatment in observation group［（130±11）, （129±13）mmHg vs （163±7）mmHg； 26（18，62）, 13（7，31）mg/L vs 47（31，98）mg/L］（P＜0.05）. Urinary microalbumin level significantly decreased 6, 9 months after treatment compared to that before treatment in control group［33（19，49）, 18（7，33）mg/L vs 52（41，119）mg/L］（P＞0.05）. Blood pressure and urinary microalbumin level showed no significant differences between groups before and 3, 6, 9 months after treatment（P＞0.05）. Levels of total cholesterol, triacylglycerol, serum creatinine and glycosylated hemoglobin had no significant differences between groups before and after treatment（P＞0.05）. The total effective rate in observation group was significantly higher than that in control group［92.6%（75/81） vs 61.7%（50/81）］（P＝0.016）. There was no severe adverse reaction occurred in both groups. Conclusion    Irbesartan and valsartan treating DN with hypertension can effectively reduce urinary microalbumin level; irbesartan is more effective in lowering systolic blood pressure; both drugs have good clinical safety.

  【Key words】Diabetic nephropathy;Hypertension;Irbesartan;Valsartan