AngⅡ受体拮抗剂对糖尿病肾病蛋白尿的治疗效果及分析  

Effect of angiotensin Ⅱ receptor antagonist on proteinuria in diabetic nephropathy

作　　者：刘永军 潘健涛[2] 祝立志 欧列斌 

机构地区：[1]广东省佛山市禅城区中心医院肾内科,528030 [2]中山大学第一附属医院肾内科,广州510080

出　　处：《广州医药》2005年第1期28-30,共3页Guangzhou Medical Journal

摘　　要：目的　调查血管紧张素Ⅱ (AngⅡ )受体拮抗剂对糖尿病肾病蛋白尿是否有明确的疗效和对肾功能的保护作用。方法　选 4 7例糖尿病肾病患者进入该前瞻性研究 ,其血糖血压均控制在理想水平。随机分为治疗组 2 4例 ,对照组 2 3例 ,两组降压、降糖等治疗措施相仿 ,而治疗组加用AngⅡ受体拮抗剂厄贝沙坦 0 3g ,每日 1次。 结果　治疗 8周后 ,治疗组尿蛋白为 (1 95± 0 6 5 )g/2 4h ,与治疗前的 (3 14± 1 2 2 ) g/2 4h相比明显下降 (P <0 0 1) ,与对照组的 (3 0 1± 1 2 5 ) g/2 4h比较 ,差异有显著性 (P <0 0 1) ,对照组血肌酐为 (2 2 4 5± 2 5 6 ) μmol/L ,与治疗前的 (175 3± 2 2 8) μmol/L相比明显上升 (P <0 0 1) ,与治疗组的 (115 6± 34 2 ) μmol/L比较 ,存在显著性差异 (P <0 0 1)。结论　AngⅡ受体拮抗剂具有降低糖尿病肾病的尿蛋白量 ,以及保护肾功能的作用。Objective To investigate the effects of Angiotensin Ⅱ receptor antagonist on proteinuria in patients of diabetic nephropathy and its protection of renal function. Methods 47 patients with diabetic nephropathy were randomly divided into two groups,23 in control group and 24 in treatment group.All patients were with stable blood pressure and plasma glucoses were controlled to an ideal level.They all received similar therapy to control blood pressure and plasma glucose,but the patients in treatment group also recived Angiotensin Ⅱ receptor antagonist Irbesartan 0.3g per day. Results After 8 weeks,the mean proteinuria level in treatment group declined from (3.14±1.22)g/24h to (1.95±0.65)g/24h.It was significant when compared to that of control group,which was (3.01±1.25)g/24h (P<0.01).At the same time,the blood creatinine of control group increased from (175.3±22.8)μmol/L to (224.5±25.6)μmol/L.It is also significant when compared to the (115.6±34.2)μmol/L in treatment group (P<0.01). Conclusion Angiotensin Ⅱ receptor antagonist can surely decrease proteinuria and protect renal function in diabetic nephropathy.

关 键 词：AngⅡ受体拮抗剂 糖尿病肾病 蛋白尿 治疗 

分 类 号：R587.2[医药卫生—内分泌] R695.2[医药卫生—内科学]