目的观察依那普利联合人胰岛素治疗糖尿病肾病(DN)的临床效果。方法将220例DN患者随机分为研究组和对照组各110例。对照组采取常规降脂抗凝治疗,研究组在对照组基础上给予依那普利和人胰岛素治疗。治疗后比较2组临床疗效和3个月及6个月血肌酐、糖化血红蛋白(Hb A1c)、餐后血糖(PBG)、空腹血糖(FBG)、血清尿素氮(BUN)、血白蛋白(ALB)及24h尿蛋白量(24h UPro)等各项观察指标。结果研究组总有效率为97.27%高于对照组的83.64%,差异具有统计学意义(P<0.05)。治疗前2组血肌酐、Hb A1c、PBG、FBG、24h UPro、BUN和ALB水平差异无统计学意义(P>0.05)。治疗后,2组第3个月、6个月时Hb A1c、PBG、FBG及24h UPro等指标均较治疗前均有所下降,且研究组下降幅度明显大于对照组(P<0.05);2组血肌酐、BUN及ALB等指标治疗前后比较差异无统计学意义(P>0.05)。结论采用依那普利联合人胰岛素治疗DN疗效较好,值得推广应用。 Objective To observe the clinical efficacy of enalapril combined with insulin in the treatment of diabetic nephropathy (DN). Methods 220 patients with DN were randomly divided into study group and control group of 110 cases. Control group to take conventional lipid-lowering anticoagulant therapy, the study group was given enalapril and human insulin treatment on the basis of the control group. After treatment, the clinical efficacy and serum creatinine, Hb A1c, postprandial blood glucose (PBG), fasting blood glucose (FBG), serum urea nitrogen (BUN) and serum albumin (ALB) were compared between the two groups at 3 months and 6 months ) And 24h urinary protein (24h UPro) and other indicators. Results The total effective rate was 97.27% in the study group and 83.64% in the control group, the difference was statistically significant (P <0.05). The levels of serum creatinine, Hb A1c, PBG, FBG, 24h UPro, BUN and ALB in the two groups before treatment were not significantly different (P> 0.05). After treatment, the indexes of Hb A1c, PBG, FBG and 24h UPro in the 3rd and 6th months in both groups decreased compared with those before treatment, and the decrease in the study group was significantly greater than that in the control group (P <0.05); 2 There was no significant difference in serum creatinine, BUN and ALB before and after treatment (P> 0.05). Conclusions Enalapril combined with human insulin treatment of DN better effect, it is worth promoting.