安体舒通联合氢氯噻嗪对2型糖尿病肾病蛋白尿的影响  

Effect of spironolactone plus hydrochlorothiazide on type 2 diabetic patients with albuminuria

作　　者：万青松[1] 谢红萍[1] 杨波[1] 

机构地区：[1]南华大学附属第一医院肾内科,湖南衡阳421001

出　　处：《中国现代医学杂志》2015年第5期57-60,共4页China Journal of Modern Medicine

摘　　要：目的探讨安体舒通联合氢氯噻嗪治疗2型糖尿病肾病的安全性及其对蛋白尿的影响。方法将2型糖尿病肾病患者随机分为3组,治疗组(安体舒通+氢氯噻嗪)、安体舒通组、氢氯噻嗪组,每组20例。治疗组给予安体舒通40 mg/d+氢氯噻嗪25 mg/d口服;安体舒通组予以安体舒通40 mg/d口服;氢氯噻嗪组予25 mg/d口服,持续3个月,定期测量患者血压、生化指标及24 h尿蛋白定量。结果与氢氯噻嗪组比较,治疗组及安体舒通组24 h尿蛋白显著下降(P<0.001);安体舒通组血钾显著上升(P=0.002),治疗组及氢氯噻嗪组血钾无显著变化。结论安体舒通联合氢氯噻嗪可以显著降低2型糖尿病患者的蛋白尿而不升高血钾。【Objective】 To investigate the safety and the effect of spironolactone and hydrochlorothiazide on the proteinuria in type 2 diabetic nephropathy. 【Methods】 Sixty type 2 diabetic patients with nephropathy were randomly divided into three equal groups： treatment group（spironolactone 40 mg / d plus hydrochlorothiazide 25 mg / d）, spironolactone group（spironolactone 40 mg / d）, hydrochlorothiazide group（hydrochlorothiazide25 mg / d）. The therapies continued for 3 months. Blood pressure, biochemical parameters and 24 h urine protein were determined for each patient at regular intervals.【Results】 Urine protein of 24 h was reduced in the patients of the treatment group and the spironolactone group compared to that in the hydrochlorothiazide group（P 〈 0.001）. Serum potassium in the spironolactone group showed a significant increase（P = 0.002）, but it did not change in the treatment group or the hydrochlorothiazide group. 【Conclusion】 Spironolactone plus hydrochlorothiazide can significantly reduce albuminuria in type 2 diabetic nephropathy without increasing serum potassium.

关 键 词：糖尿病肾病 安体舒通 氢氯噻嗪 蛋白尿 

分 类 号：R969.4[医药卫生—药理学]