目的 观察氯沙坦联合阿托伐他汀对糖尿病肾病(diabetic nephropathy, DN)内皮功能及血管弹性的影响。方法 65例糖尿病肾病合并高血压患者,按照随机信封法分为3组:氯沙坦组,50 mg/d;阿托伐他汀组,20 mg/d;联合治疗组,氯沙坦50 mg/d+阿托伐他汀20 mg/d。观察治疗6个月后肱动脉血流介导的血管舒张功能(FMD)和肱-踝动脉脉搏波速度(baPWV)的变化情况。结果 治疗6个月后,联合治疗组FMD为(10.61±0.52),与氯沙坦组(7.28±0.59)或阿托伐他汀组(6.87±0.62)比较,差异有统计学意义(P<0.05);联合治疗组baPWV为(8.56±0.44) cm/s,与氯沙坦组(10.8±0.62) cm/s或阿托伐他汀组(11.2±0.41) cm/s比较,差异有统计学意义(P<0.05)。结论 氯沙坦和阿托伐他汀联合使用有助于进一步改善DN血管内皮功能及动脉血管的弹性度。

Objective To study the effects of losartan combined with atorvastatin on the endothelial function and arterial elasticily elasticity in patients with diabetic nephropathy. Methods A total of 65 patients with diabetic nephropathy were enrolled and randomized to losartan group (only losartan 50 mg/d), atrovastatin group (only atorvastatin 20 mg/d) and combined group (losartan 50 mg/d+atorvastatin 20 mg/d) by envelopes. The brachial artery flow-mediated dilation (FMD) and brachial-ankle pulse wave velocity (baPWV) were compared among the three groups during six-month follow-up. Results After six-month follow-up, the levels of FMD(10.61?0.52) and baPWV (8.56?0.44 cm/s) in the combined group improved much more significantly than those in losartan group[FMD: (7.28?0.59); baPWV: (10.8?0.62) cm/s] or atrovastatin group[FMD: (6.87?0.62); baPWV: (11.2?0.41) cm/s] (P<0.05). Conclusions Losartan combined with atorvastatin benefits the endothelial function and arterial elasticity in diabetic nephropathy.