贵州医科大学学报

2016, v.41;No.186(03) 359-361+365

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替米沙坦对冠心病合并糖尿病肾病患者心室功能重构和肾脏预后的影响
Study of Telmisartan and Enalapril on Ventricular Remodeling and Renal Prognosis of Patients with Coronary Heart Disease and Diabetic Nephropathy

孙丹;辛乃冰;
SUN Dan;XIN Naibing;Department of Cardiology,Heart Diagnosis Center,People's Hospital of Liaoning;Community Health Care Center of Liaozhong County;

摘要(Abstract):

目的:探讨替米沙坦对冠心病合并糖尿病肾病患者心室功能重构和肾脏预后的影响。方法:60例冠心病合并糖尿病肾病患者随机分为替米沙坦组(32例,口服替米沙坦80 mg/d)和对照组(28例,口服依那普利10 mg/d),比较治疗前和治疗12周时两组患者左室射血分数(LVEF)、左室舒张末直径(LVEDd)、平均收缩压和舒张压、血清肌酐水平、三餐前平均空腹血糖和三餐后2 h平均血糖水平、24 h尿蛋白含量。结果:两组患者治疗后的LVEF均较治疗前升高,LVEDd较治疗前降低,替米沙坦组的LVEF显著高于对照组,LVEDd显著低于对照组(P<0.05);治疗12周时的血清肌酐水平和24 h尿蛋白含量均低于治疗前,替米沙坦组降低更明显(P<0.05);而两组患者治疗前后的平均空腹血糖和餐后2 h平均血糖水平变化不明显(P>0.05)。结论:替米沙坦对冠心病合并糖尿病肾病患者的心室功能重构和肾脏预后效果优于依那普利。
Objective: To investigate the clinical value of telmisartan and enalapril on ventricular remodeling and renal prognosis in patients with coronary heart disease and diabetic nephropathy. Methods: A total of 60 patients with coronary heart disease and diabetic nephropathy were randomly divided into telmisartan group( n = 32,take 80 mg / d orally) and enalapril group( n = 28,take 10 mg / d orally). Then comparing LVEF,LVEDd,d SBP DBP,Scr,average FPG before three meals,average blood glucose level 2h after three meals and 24 h Upro. Results: Left ventricular ejection fraction( LVEF) in telmisartan group was significantly higher and left ventricular end diastolic diameter( LVEDd) was significantly lower than enalapril group( P < 0. 05). The 12 weeks serum creatinine level and 24 h urinary protein were lower than before treatment,and telmisartan group decreased more obvious( P < 0. 05). Average FPG and average blood glucose level 2 h after three meals didn 't present obvious changes before and after treatment( P > 0. 05). Conclusion: Telmisartan is better for patients with coronary heart disease and diabetic nephropathy on ventricular remodeling and renal prognosis than enalapril.

关键词(KeyWords): 替米沙坦;依那普利;冠状动脉硬化;糖尿病肾病;左室射血分数;左室舒张末直径;血清肌酐
telmisartan;enalapril;coronary heart disease;diabetic nephropathy;Left ventricular ejection fraction;Left ventricular end diastolic diameter;serum creatinine

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作者(Author): 孙丹;辛乃冰;
SUN Dan;XIN Naibing;Department of Cardiology,Heart Diagnosis Center,People's Hospital of Liaoning;Community Health Care Center of Liaozhong County;

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DOI: 10.19367/j.cnki.1000-2707.2016.03.033

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