开搏通逆转糖尿病肾小球高滤过的临床评价(附27例分析)  

Reverse effect of captopril on glomerular hyperfiltration in diabetes mellitus patients:Report of 27 cases

作　　者：赵淑好[1] 林军[1] 李志雄[1] 刘东晖[1] 黄凌宁[1] 潘时中[1] 严孙杰[1] 杨立勇[1] 

机构地区：[1]福建医科大学附属第一医院,350005

出　　处：《福建医药杂志》2005年第3期29-30,共2页Fujian Medical Journal

基　　金：福建医科大学附属第一医院青年科研基金资助课题

摘　　要：目的观察血管紧张素转化酶抑制剂(ACEI)———开搏通对糖尿病肾小球高滤过患者的短期治疗作用。方法对27例尿白蛋白阴性、血压正常、高肾小球滤过率的糖尿病患者,采用开搏通治疗1个月,比较治疗前后肾小球滤过率(GFR)与尿白蛋白排泄率(UAER)、血压等指标变化,评价开搏通逆转糖尿病肾小球高滤过的临床效果。结果GFR从175.1±24.3ml/min降至138.5±30.0ml/min(P<0.01),27例糖尿病患者中22例GFR明显下降,4例无明显变化,1例略升高;UAER较治疗前明显下降(P<0.05);治疗前后血压均无明显变化。结论开搏通有明显逆转糖尿病患者高肾小球滤过率的作用,且不依赖于血压的下降,具有独特的肾脏保护作用。Objective To evaluate the short-term effects of captopril (an inhibitor of the angiotensin-transforming enzyme)on the glomerular filtration rate(GFR)and urinary albumin excretion rate(UAER)of normoalbuminuric normotensive diabetes mellitus patients with glomerular hyperfiltration.Methods Overall twenty-seven normoalbuminuric(UAER<30 micrograms/min)normotensive diabetes mellitus patients with glomerular hyperfiltration(GFR>or=140 ml/min)participated in the study.GFR(  99m Tc-DTPA dynamic renography)and UAER(RIA)were measured at baseline and after 1 month on captopril(25 mg p.o.twice daily)administration.Results GFR statistically significantly decreased after treatment on captopril(175.1+/-24.3,138.5+/-30.0 ml/min,P<0.01).Also,a significant decrease in UAER(8.4+/-5.3,4.7+/-3.4 micrograms/min,P<0.05).But,systolic(118.1+/-19.7,117.4+/-22.6 mmHg,P>0.05) and diastolic (72.7± 97.0± 9 mmHg,P>0.05) blood pressure did not change.Conclusions Captopril has reverse effect on the GFR and UAER of normoalbuminuric normotensive diabetes mellitus patients with glomerular hyperfiltration.This beneficial effect independent of its blood pressure-lowering effects.It is assumed that elimination of hyperfiltration due to the treatment with the inhibitors of the angiotensin-transforming enzyme may be an effective means of diabetic nephropathy prevention.This issue needs to be investigated further in a large scale long-term clinical trial.

关 键 词：开搏通 糖尿病肾小球高滤过 血管紧张素转化酶抑制剂 血压 药物治疗 肾脏保护 

分 类 号：R587.1[医药卫生—内分泌]