【www.zhangdahai.com--精神文明建设】
[摘要] 目的：探讨ACEI类药物治疗糖尿病肾病的临床疗效。方法：将本院糖尿病专科2009年4月～2010年10月收治的120例患者按照随机数字表随机分成3组，①血管紧张素转换酶抑制剂（ACEI）组，给予贝那普利治疗；②血管紧张素受体拮抗剂（ARB）组，给予缬沙坦治疗；③ACEI+ARB联合用药组，给予缬沙坦与贝那普利。统计分析患者治疗前后24 h内的尿蛋白以及血肌酶变化情况，并观察比较各组的耐受性、临床效果与不良反应。结果：ACEI组、ARB组、联合用药组治疗3个月后尿蛋白分别为0.729、1.000、0.825 g/L，治疗6个月后分别为0.500、0.375、0.305 g/L，ACEI组、ARB组患者的治疗3、6个月后的尿蛋白及血肌酶变化对比联合用药有一定差异（P＜0.05）。结论：ACEI类药物进行联合用药对糖尿病患者的肾功能保护作用会更加明显。
[关键词] ACEI类药物；ARB类药物；糖尿病肾病；并发症
[中图分类号] R587.2 [文献标识码] A [文章编号] 1674-4721（2012）01（a）-055-02
The clinical effect analysis of ACEI for the diabetic nephropathy
ZHANG Mengmeng
Department of Medical, People"s Hospital of Jianggan District, Zhejiang Province, Hangzhou 310021, China
[Abstract] Objective: To investigate the clinical efficacy of ACEI drugs in treatment of diabetic nephropathy. Methods: In our hospital diabetes specialist April 2009 to October 2010 120 patients were randomly divided into three groups according to random number table, ① angiotensin-converting enzyme inhibitor (ACEI) group, were given benazepril; ② angiotensin receptor blocker (ARB) group were given valsartan; ③ ACEI and ARB combination treatment group, were given valsartan and benazepril. Statistical analysis before and after treatment within 24 h urine protein and serum muscle enzyme changes, and the tolerance of each group, the clinical effects and adverse reactions were observed. Results: Urinary protein of ACEI group, ARB group, the combined treatment group were 0.729, 1.000, 0.825 g/L after 3 months treatment respectively, and 0.500, 0.375, 0.305 g/L after 6 months of treatment, ACEI group, ARB treatment of patients 3 months, 6 months after the urine protein and serum muscle enzymes in combination with certain changes in contrast differences (P 2.2 3组患者治疗前后24 h尿蛋白的改变
ACEI组、ARB组、联合用药组治疗3个月后尿蛋白分别为0.729、1.000、0.825 g/L，治疗6个月后分别为0.500、0.375、0.305 g/L，ACEI组、ARB组患者治疗3、6个月后的尿蛋白及血肌酶变化对比联合用药有一定差异（P＜0.05），其中ARB组与联合用药组的治疗3、6个月后的尿蛋白及血肌酶变化对比差异明显高于ACEI组与联合用药组（P＜0.05），差异具有统计学意义，表明ACEI药物进行联合用药对糖尿病患者的肾功能保护作用会更加明显。见表1。
2.3 3组患者治疗前后的血肌酐变化情况
见表2。
2.4 3组患者治疗前后血压变化
治疗6个月时所有患者血压较治疗前都有了明显下降（P
