目的 观察羟苯磺酸钙联合氯沙坦治疗老年2型糖尿病肾病合并高血压的临床疗效。方法 选取2012年11月—2015年3月郧阳医学院堰桥医院肾病内科收治的老年2型糖尿病肾病合并高血压患者115例,随机分为对照组(n=57)和治疗组(n=58)。对照组患者口服氯沙坦钾片50 mg/次,1次/d;治疗组患者在对照组治疗基础上口服羟苯磺酸钙胶囊,0.5 g/次,3次/d。两组患者均连续治疗12周。观察两组的临床疗效,同时比较两组治疗前后收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、血糖、尿微量蛋白、24 h尿蛋白排泄率(UAER)、血肌酐(Scr)、血尿素氮(BUN)的变化情况。结果 治疗后,对照组和治疗组的总有效率分别为77.19%、91.38%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者SBP、DBP、MAP、尿微量蛋白、UAER较治疗前均显著降低,同组治疗前后差异有统计学意义(P<0.05);且治疗组这些观察指标的改善程度优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后两组Scr、BUN均显著下降,同组治疗前后差异有统计学意义(P<0.05),但治疗后两组比较差异无统计学意义。结论 羟苯磺酸钙联合氯沙坦治疗老年2型糖尿病肾病合并高血压具有较好的临床疗效,可显著改善患者的肾功能,降低尿微量蛋白和血压,且安全性好,具有一定的临床推广和应用价值。

Objective To observe the clinical effects of calcium dobsilate combined with losartan in treatment of elderly type 2 diabetic nephropathy with hypertension. Methods Patients (115 cases) with elderly type 2 diabetic nephropathy with hypertension in Department of Kidney Disease Internal Medicine of Yanqiao Hospital of Yunyang Medical College from November 2012 to March 2015 were randomly divided into control (n = 57) and treatment groups (n = 58). The patients in the control group were po administered with Losartan Potassium Tablets, 50 mg/time, once daily. The patients in the treatment group were po administered with Calcium Dobsilate Capsules on the basis of the control group, 0.5 g/time, three times daily. The patients in two groups were treated for 12 weeks. After treatment, the clinical efficacies were evaluated, and SBP, DBP, MAP, blood sugar, urine micro protein, UAER, Scr, and BUN before and after treatment in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 77.19% and 91.38%, respectively, and there were differences between two groups (P< 0.05). After treatment, SBP, DBP, MAP, urine micro protein, and UAER in two groups were significantly decreased, and the difference was statistically significant in the same group (P< 0.05). After treatment, those observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P< 0.05). Scr and BUN in two groups were significantly decreased, and the difference was statistically significant in the same group (P< 0.05). But there was no statistically significant difference between two groups after treatment. Conclusion Calcium dobsilate combined with losartan has clinical curative effect in treatment of elderly type 2 diabetic nephropathy with hypertension, and can significantly improve the kidney function, also can decrease the urine micro protein and blood pressure, which has a certain clinical application value.