2型糖尿病慢性肾脏疾病患者厄贝沙坦治疗后血浆氨基末端脑钠肽前体水平变化及其临床意义  

The change of plasma N-terminal pro-brain natriuretic peptide and its clinical significance after using Irbesartan to treat chronic kidney disease in T2DM patients

作　　者：黄启亚[1] 杨彩娴[1] 麦智敏[1] 梁大立[1] 郭洁峰[1] 梁俊兴[1] 李绍清[1] 贾文娟[1] 严励[2] 

机构地区：[1]广东省清远市人民医院内分泌科,511518 [2]中山大学附属孙逸仙纪念医院内分泌科

出　　处：《中国糖尿病杂志》2013年第10期874-876,共3页Chinese Journal of Diabetes

基　　金：广东省清远市科技局项目(2010B95)

摘　　要：目的通过观察糖尿病慢性肾脏疾病(CKD)患者厄贝沙坦治疗后血浆氨基末端脑钠肽前体(NT-proBNP)水平变化,探讨NT-proBNP在CKD患者中的临床意义。方法选择T2DM患者167例,根据尿白蛋白/肌酐比值(UACR)分为大量白蛋白尿(A)组(UACR≥300mg/g)54例、微量白蛋白尿(B)组(30mg/g≤UACR<300mg/g)60例、尿白蛋白正常者(C)组53例。所有研究对象给予厄贝沙坦150mg/g,连续24周。比较各组治疗前后NT-proBNP水平变化及其与Cr、UACR变化的关系。结果经厄贝沙坦治疗后,A、B组NT-proBNP下降(P<0.01)。A、B组NT-proBNP与UACR、Cr呈正相关(r=0.730、0.546,P=0.000)。结论厄贝沙坦降低CKD患者尿蛋白的同时伴NT-proBNP水平下降,提示NT-proBNP可能成为诊断早期CKD的标志物及评估CKD治疗效果的辅助手段之一。Objective To observe the change of the level of N-terminal pro-brain natriuretic peptide （NTproBNP） after irbesartan therapy in the T2DM patients with chronic kidney disease（CKD）. Methods One hundred and fourteen T2DM patients with CKD and 53 T2DM patients with normal urine protein （C）group were studied. According to the urinary albumin creatinine ratio（UACR）, the 114 T2DM patients with CKD were divided into the macroalbuminuria （A） group （54 cases with UACR≥300μg/mg, and the microalbuminuria （B） group, （60 cases with 30 mg/g≤UACR〈300 mg/g）. All patients were given Irbesartan 150 mg every day, continuously for 24 weeks. The plasma levels of NT-proBNP, Cr, HbA1 c, and UACR were measured before and after treatment. The change of level of NT-proBNP in each group after treatment and the relationship of the changed level of NT-proBNP with Cr and UACR were analyzed and compared. Results After treatment, the level of NT-proBNP of A,B group was declined significantly. The changed level of NT-proBNP in the A, B group was positively related with Cr and UACR（r=0. 730, 0. 546, P= 0. 000）. Conclusion Irbesartan reduces urine protein of T2DM patients with CKD, at the same time the NT-proBNP level is reduced subsequently. It suggests that NT-proBNP may become an early new marker for screening CKD and a supplementary means to evaluate the treatment effect of TEDM patients with CKD.

关 键 词：糖尿病 2型 血浆氨基末端脑钠肽前体 厄贝沙坦 尿白蛋白 肌酐比值 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]