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目的：探讨左旋氨氯地平联合氯沙坦治疗2 型糖尿病肾病（T2DN）合并高血压的疗效及对血压和肾功能的影响。方法：采用随机数字表法将2010 年1 月至2013 年1 月本院门诊及住院部收治的260 例T2DN 合并高血压患者分为实验组和对照组，每组患者130 例，实验组给予左旋氨氯地平和氯沙坦口服联合治疗，对照组仅给予左旋氨氯地平口服治疗，对比两组疗效，并观察两组治疗前后的收缩压（SBP）和舒张压（DBP）、血肌酐（Scr）水平、尿微量白蛋白（UMALB）/ 尿肌酐（Ucr）水平和24 h UMALB 水平。结果：实验组的总有效率90.77%显著高于对照组的78.46%（P<0.05）；治疗后两组SBP、DBP、脉压差、SCr、UMALB/Ucr 及 24h UMALB水平均有显著下降（P<0.05），且实验组均显著低于对照组（P<0.05）。结论：左旋氨氯地平联合氯沙坦不仅可有效降低 T2DN 合并高血压患者血压，还可有效减少尿液中蛋白的排放，保护患者的肾脏功能，疗效显著，值得推广。

英文摘要:

Objective:To investigate the effect of L-amlodipine combined with losartan and its influence on blood pressure and renal function of patients with type 2 diabetic nephropathy (T2DN) complicated with hypertension.Methods:A total of 260 patients with T2DN complicated with hypertension, who were treated in Shanghai Tongren Hospital from January 2010 to January 2013, were randomly divided into study group (n=130) and control group (n=130). The study group was treated with oral L-amlodipine combined with losartan, while the control group was treated only with oral L-amlodipine. Then the effect in the two groups was compared, and the levels of systolic blood pressure (SBP), diastolic blood pressure (DBP), serum creatinine (Scr), urine micro-albumin(UMALB)/urinary creatinine (Ucr) and 24 h UMALB in two groups before and after treatment were observed.Results:The total effective rate (90.77%) in the study group was significantly higher than that (78.46%) in the control group (P<0.05). The levels of SBP, DBP, pulse pressure difference, Scr, UMALB/Ucr and 24 h UMALB decreased in the two groups after treatment(P<0.05), and the indexes of study group were significantly lower than those of control group (P<0.05).Conclusion:L-amlodipine combined with losartan can not only significantly decrease the blood pressure of patients with T2DN complicated with hypertension, but also reduce the discharge of urine protein and effectively protect the renal function, which is worthy of promotion.

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