摘要
目的本研究旨在评估厄贝沙坦在治疗高血压(HBP)合并糖尿病肾病(DN)患者中对肾病进展的延缓作用。方法本研究为单中心、随机、平行对照临床试验,共纳入180例HBP合并DN患者。患者按照区组随机方式1∶1分配至厄贝沙坦组和氨氯地平组。结果治疗12个月后,厄贝沙坦组估算肾小球滤过率(e GFR)下降值低于氨氯地平组(P=0.026)。CKDⅠ~Ⅱ期患者中,厄贝沙坦组e GFR下降值低于氨氯地平组(P=0.038),在CKDⅢ期患者中结果类似(P=0.042)。12个月时厄贝沙坦组24 h蛋白尿降低水平显著高于氨氯地平组(P<0.001),2组间DBP(P=0.534)和SBP(P=0.386)下降值无统计学差异。结论厄贝沙坦治疗HBP合并DN患者,可以一定程度延缓患者的肾病进展。
Objective To evaluate the effect of irbesartan treatment on progression of nephropathy in patients with concurrent diabetic nephropathy （DN） and high blood pressure （HBP）. Methods This study enrolled 180 patients with DN and HBP in a single-center, randomized, parallel group clinical trial. All patients were randomized in a 1 ： 1 ratio to irbesartan and amlodipine groups, using a soft- ware-generated block randomization method. Results After 12 months of treatment, the estimated glomerular filtration rate （eGFR） in the irbesartan group was markedly lower than in the amlodipine group （P = 0.026）. When grouped according to the Chronic Kidney Disease （CKD） Epidemiology Collaboration equation,results showed that in stage 1-2 CKD and stage 3 CKD patients, reductions in eGFR in the irbesartan group were notably less than in the amlodipine group （P = 0.009 and P = 0.028, respectively）. At 12 months,the decrease in urinary protein excretion （g/24 h） in the irbesartan group was obviously greater than in the amlodipine group （P 〈 0.0131 ） ;however, no difference in reduction of systolic and diastolic BP was found between groups （P = 0.534 and P = 0.386, respectively）. Conclusion Irbesartan can ameliorate the progression of nephropathy in patients with coneun＇ent DN and HBP to some extent.
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2017年第11期1024-1027,共4页
Journal of China Medical University
关键词
厄贝沙坦
氨氯地平
高血压
糖尿病肾病
估算肾小球滤过率
irhesartan
amlodipine
high blood pressure
diabetic nephropathy
estimated glomerular filtration rate
