Effect of Enalapril and Losartan Combined Therapy on Elderly Patients with Diabetes Nephropathy and Hypertension
Objective:To investigate the effect of Enalapril combined with Losartan in the treatment of elderly patients with diabetic nephropathy(DN)and hypertension.Method:A total of 160 elderly patients with DN and hypertension admitted to the Gansu Rehabilitation Center Hospital from January 2021 to December 2022 were selected as the study objects,and they were divided into experimental group and control group by envelope random method,with 80 cases in each group.The control group received single Losartan treatment,and the experimental group received combination therapy with Enalapril and Losartan.The clinical efficacy,renal function indexes,blood pressure,levels of serum soluble tumor necrosis factor receptor Ⅰ(sTNFRⅠ),soluble CD146(sCD146)and Fetuin-A were compared between the two groups.Result:The total effective rate of experimental group was 93.75%,which was higher than 83.75%of control group,and the difference was statistically significant(P<0.05).After 8 weeks of treatment,creatinine,brain natriuretic peptide,uric acid,diastolic blood pressure and systolic blood pressure in two groups were lower than those before treatment,and those in the experimental group were lower than those in the control group,the differences were statistically significant(P<0.05).After 8 weeks of treatment,sTNFRⅠ and sCD146 in two groups were lower than those before treatment,Fetuin-A was higher than that before treatment,and sTNFRⅠ and sCD146 in experimental group were lower than those in control group,Fetuin-A was higher than that in control group,the differences were statistically significant(P<0.05).Conclusion:The combination therapy of Enalapril and Losartan has a significant effect in the treatment of elderly patients with DN and hypertension,which helps to up-regulate the expression of serum Fetuin-A,improve renal function indicators,reduce blood pressure,and promote the reduction of serum sTNFRⅠ and sCD146 levels.