贝那普利与缬沙坦联合治疗早期糖尿病肾病临床疗效观察被引量：12

Renoprotective effects of dual blockade of renin-angiotensin system in diabetic nephropathy

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摘要目的:探讨贝那普利与缬沙坦联合治疗对早期糖尿病肾病的肾保护作用。方法:60例合并早期糖尿病肾病的2型糖尿病患者,随机分为3组,每组各20例。贝那普利组应用贝那普利10 mg/d,缬沙坦组应用缬沙坦80 mg/d,联合用药组应用贝那普利10 mg/d和缬沙坦80 mg/d。观察治疗前后尿白蛋白排出量(UAE)、平均动脉压(MAP)、尿转化生长因子β(TGF-β)、糖化血红蛋白(HbA1c)、肾功能等指标的变化。结果:3组治疗后,UAE、尿TGF-β水平均显著下降(P<0.01),联合用药组下降幅度显著大于贝那普利组和缬沙坦组(P<0.05)。各组治疗后MAP显著降低(P<0.05),各组间治疗前后血压变化差异无统计学意义(P>0.05)。结论:贝那普利和缬沙坦联合应用较单独应用可显著降低早期糖尿病肾病患者的微量白蛋白尿,具有独立于降血压之外的肾脏保护作用。 Objective： To evaluate the renoprotective effects as reflected by short-term changes in albuminuria and urinary level of transforming growth factor-β（TGF-β） of dual blockade of the renin-angiotensin system （RAS） by an angiotensin Ⅱ receptor blocker （ARB, valsartan） and an ACE inhibitor （ACEI, benazapril） in patients with type 2 diabetic nephropathy. Methods： A total of 60 patients with type 2 diabetes along with early nephropathy were divided into three groups, which were treated with the ARB valsartan 80 mg daily, the ACEI benazapril 10 mg daily or both ARB and ACEI daily. At the end of treatment, the albuminuria in 24-h urinary , the mean arterial blood pressure （MAP）, and the urinary TGF-β were measured. Results： After 12 weeks treatment, MAP of 3 groups significantly decreased compared with prethempy, and the level of albuminuria and urinary TGF-βin the group of dual blockade of the RAS by ACEI and ARB also significantly declined compared with the groups of monoblockade of the RAS by ACEI or ARB treatment alone. Changes in albuminuria did not correlate to changes in MAP. Conclusion： Dual blockade of the RAS provides su- perior short-term renoprotection independent of systemic blood pressure changes in patients with type 2 diabetes with nephropathy.

作者江蓓李宪花杨向东宋剑郭玲胡昭

机构地区山东大学齐鲁医院泌尿内科

出处《山东大学学报（医学版）》 CAS 北大核心 2006年第9期896-899,共4页 Journal of Shandong University:Health Sciences

关键词糖尿病肾病贝那普利缬沙坦肾保护 Diabetic nephropathy Benazapril Valsartan Renoprotection

分类号 R692.3 [医药卫生—泌尿科学]

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