目的 探讨贝那普利与缬沙坦单用或联用对老年糖尿病肾病（DN）患者的疗效。方法 入选60例老年DN患者，随机分为3组，分别为贝那普利组、缬沙坦组及联合组，其中贝那普利组（20例）予贝那普利10 mg/d，缬沙坦组（20例）予缬沙坦80 mg/d，联合组（20例）予贝那普利10 mg/d联合缬沙坦80 mg/d。比较3组治疗前后平均动脉压（MAP）、血脂、常用肾功能指标、尿白蛋白排出量（UAE）、尿转化生长因子β（TGF-β）水平变化及不良反应。结果 治疗后，3组血脂水平均无明显变化，MAP明显降低，同组治疗前后比较差异有统计学意义（P<0.05），但组间比较无明显差异。治疗后，3组血肌酐（Scr）均明显降低，同组治疗前后比较差异有统计学意义（P<0.05）；且联合组明显低于贝那普利组和缬沙坦组，差异有统计学意义（P<0.05）。治疗后，贝那普利组和缬沙坦组血尿酸（UA）无明显变化，联合组UA明显降低，同组治疗前后比较差异有统计学意义（P<0.05），且明显低于贝那普利组和缬沙坦组，差异有统计学意义（P<0.05）。治疗后，3组血尿素氮（BUN）均明显降低，同组治疗前后比较差异有统计学意义（P<0.05），但组间比较无明显差异。治疗后，3组UAE、TGF-β均明显降低，同组治疗前后比较差异有统计学意义（P<0.05）；且联合组明显低于贝那普利组和缬沙坦组，差异有统计学意义（P<0.05）。组间不良反应无明显差异。结论 贝那普利联合缬沙坦治疗老年DN的疗效明显优于两药单用，对血压、肾功能的改善作用更显著。

Objective To investigate the effect of Benazepril Hydrochloride Tablets and Valsartan alone or in combination on elderly patients with diabetic nephropathy. Methods 60 elderly patients with DN were selected, 20 cases were given Benazepril Hydrochloride Tablets 10 mg/d, 20 cases were given Valsartan 80 mg/d and the other 20 cases were given Benazepril Hydrochloride Tablets 10 mg/d combination Valsartan 80 mg/d, as Benazepril group, valsartan group and combination group. The mean arterial pressure (MAP), blood lipid, renal function, urinary albumin excretion (UAE), urinary transforming growth factor beta (TGF-β) levels and adverse reactions were compared in the three groups before and after treatment. Results After treatment, there were no significant change in serum lipid levels between the three groups, and MAP decreased significantly (P < 0.05), but there were no significant difference between the groups; the serum creatinine (Scr) of the three groups were significantly lower (P < 0.05), and of the combination group was significantly lower than that of the Benazepril group and the valsartan group (P < 0.05); the serum uric acid (UA) of the Benazepril group and the valsartan group were no significant change, while of the combination group were decreased significantly (P < 0.05), and was significantly lower than that of the Benazepril group and the valsartan group (P < 0.05); the serum urea nitrogen (BUN) of the three groups were decreased significantly (P < 0.05), but there were no significant difference between the groups; the UAE and TGF-β of the three groups were decreased significantly (P < 0.05), and of the combination group were significantly lower than those of the Benazepril group and the valsartan group (P < 0.05). Conclusion Benazepril Hydrochloride Tablets combined with valsartan in the treatment of elderly patients with DN was better than their single, which improve the effect on blood pressure and renal function more significantly.