摘要
目的 :分析、探讨影响血管紧张素转化酶抑制剂 (ACEI)抗尿蛋白作用的因素。方法 :原发性肾小球疾病患者 13 6例。分别实施卡托普利、西拉普利和依那普利各两个剂量组治疗 4个月。治疗前及治疗后每月检测平均动脉压 (MAP)、尿蛋白、尿白蛋白排泄率 (UAER)、尿钠和肾功能 ,并检测患者ACE基因表型。依据尿蛋白减少率 (UPDR )分为 :显效组 (UPDR >50 % ) 3 3例 ,良效组 (UPDR :3 0 %～ 50 % ) 49例 ,有效组 (UPDR :10 %～ 3 0 % ) 2 3例 ,无效组 (UPDR :-10 %～ 10 % ) 2 1例 ,恶化组 (UPDR <-10 % ) 10例。分析各组间ACEI种类、剂量以及上述各检测指标的变化。结果 :1.ACEI的抗尿蛋白作用 ,与ACEI种类、剂量和患者ACE基因多态性无关 ;2 .与其他组相比 ,显效组患者治疗前肾功能良好、MAP较低 ;3 .无效组和恶化组治疗过程中食盐摄入控制不良。结论 :ACEI种类、剂量和患者ACE基因多态性不影响ACEI的抗尿蛋白作用 ,肾脏疾病早期应用以及严格限制食盐摄入可提高ACEI抗尿蛋白疗效。
OBJECTIVE To investigate the susceptible factors of antiproteinuric effect of ACEIs in primary glomerular diseases.METHODS For 136 patients with primary glomerular diseases, we used a 4 months therapy, 40 cases with two doses of captopril and 51 cases with two doses of cilazapril and 45 cases with two doses of enalapril. Mean arterial pressure (MAP), urinary protein, urinary albumin excretion rate and renal function were measured at basis and after 1, 2, 3, 4 month of therapy, and ACE gene polymorphism was determined in this patients. According to urinary protein decreasing rate (UPDR), patients were divided into high effect group (UPDR>50%, 33 cases), moderate effect group (UPDR 30%～50%, 49 cases), low effect group (UPDR 10%～30%, 23 cases), non effect group (UPDR-10%～10%, 21 cases), progress group (UPDR<-10%, 10 cases). We studied the association of different ACEIs and different doses and ACE gene polymorphism and clinical index with the antiproteinuric effect of ACEIs.RESULTS 1. The different ACEIs and different doses and ACE gene polymorphism did not affect the antiproteinuric effect of ACEI; 2. The patients in the high effect group had a lower MAP and a better renal function compared to the other patients; 3. The dietary salt retriction in the non effect group and progress group was poor then the other patients.CONCLUSIONS The antiproteinuric effect of ACEI was not associated with different ACEIs and different doses and ACE gene polymorphism, early treatment and dietary salt restriction could enhance the antiproteinuric effect of ACEIs.
出处
《中国医院药学杂志》
CAS
CSCD
北大核心
2002年第11期650-654,共5页
Chinese Journal of Hospital Pharmacy
