ObjectiveTo investigate the effects of dual blocked RAS system with angiotensin-converting enzyme inhibitors (ACEI) combined with AT1 receptor blocker (ARB) in the treatment of elderly diabetic nephropathy.
MethodsOne hundred forty-one elderly patients with diabetic nephropathy were randomly divided into the ACEI group, ARB group and combined group (47 cases in each group).The ACEI group, ARB group and combined group were treated with benazepril, valsartan and benazepril combined with valsartan for 6 months, respectively.The levels of fasting plasma glucose (FPG), 2 h postprandial blood glucose (PBG2h), glycated hemoglobin (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), serum creatinine (SCr), blood urea nitrogen (BUN) and 24 h urinary microalbumin protein (UAER) before and after treatment, and incidence rate of adverse reactions in three groups were observed.
ResultsCompared with before treatment, the levels of SBP and DBP in three groups were significantly improved (P < 0.01), the levels of FPG and HbA1c in combined group were significantly improved (P < 0.01), and the levels of PBG2h in ARB group and combined group were significantly improved after treatment (P < 0.01).After treatment, the differences of the levels of PBG2h, HbA1c, SBP and DBP among three groups were statistically significant (P < 0.05 to P < 0.01), and the improvement degrees of PBG2h, HbA1c, SBP and DBP in combined group were better than that in ACEI group and ARB group (P < 0.05 to P < 0.01).Compared with before treatment, the levels of BUN, SCr and UAER in three groups were significantly improved after treatment (P < 0.01).After treatment, the differences of the levels of BUN, SCr and UAER among three groups were statistically significant (P < 0.01), and the improvement degrees of BUN, SCr and UAER in combined group were better than that in ACEI group and ARB group after treatment (P < 0.01).One case in ACEI group and 2 cases in combined group with intractable dry cough quitted the experiment, the other cases completed experiment.The incidence rates of adverse reactions in ACEI group, ARB group and combined group were 4.24%, 4.24% and 6.36%, respectively, and the difference of which was not statistically significant (P>0.05).
ConclusionsThe dual blocked RAS system with ACEI combined with ARB in treating elderly diabetic nephropathy has good effects and low incidence rate of adverse reactions, which can effectively control blood glucose, blood pressure and significantly improve the renal function, and is better than that of single ACEI or ARB and worthy of promotion.
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