双重阻断肾素-血管紧张素系统对早期糖尿病肾病的影响.pdfVIP

C嚼勰擘 雾焉 ·113· · 论著 · 双重阻断肾素一血管紧张素系统对早期糖尿病肾病的影响 杨福燕，邵凤杰 【摘要】 目的 观察血管紧张素转换酶抑制剂(ACEI)联合血管紧张素受体Ⅱ拮抗剂 (ARB)治疗早期糖尿 病肾病 (DN)的疗效。方法 将76例早期糖尿病肾病患者随机分为ACEI组、ARB组及联合治疗组，ACEI组患者给 予依那普利治疗，ARB组患者给予氯沙坦治疗，联合治疗组患者给予依那普利联合氯沙坦治疗。观察治疗前及治疗12 周后3组患者糖化血红蛋白 (HbA )、血压、尿微量清蛋白排泄率 (UAER)、血K 及肾小球滤过率 (GFR)变化。 结果 治疗前3组患者HbA 收缩压 (SBP)、舒张压 (DBP)、UAER、GFR和血K 间差别无统计学意义 (P 0．05)，而治疗后联合治疗组患者SBP、UAER与ACEI组、ARB组比较，差别有统计学意义 (P0．05)。结论 ACEI和ARB联合治疗可以双重阻断肾素一血管紧张素系统，有更强的降低UAER和收缩压的作用。 【关键词】 肾素一血管紧张素系统；血管紧张素转换酶抑制剂；血管紧张素受体Ⅱ拮抗剂；糖尿病肾病 【中图分类号】R 587．24 【文献标识码】A 【文章编号】1007—9572(2008)1B一0113—02 Dual Blockage of Renin—Angiotensin System in Patients with Early Diabetic Nephropathy：A Study of Randomized Con- trol Trial YANG Fu—yan，SHAO Feng—fie．Department ofNephropathy，the First People s Hospital ofXinxiang，Xinxiang 453000，China 【Abstract】 Objective To observe the effect of angiotensin—converting enzyme inhibitor(ACEI)combined with an— giotensin receptor blocker(ARB)on early diabetic nephropathy(DN)．Methods A randomized controlled trial was carried out in seventy—six patients with early diabetic nephropathy，who were divided into ACEI group，ARB group and a combined group． The ACEI group were given enalapril，and the ARB group losartan；The combined group received therapy of both enalapril and losartan．Clinical data was collected at baseline and after 12 weeks of treatment．．Results There were no significant differences in hemoglobin 1 c(HbA1 )，blood pressure，urina~microalbumin excretion rate(UAER)，glomerular filtration rate(GFR)， and blood K among the three groups before treatment(P0．05)；After 1 2一week therapy，the combined group were signifi— cantly different from ACEI group and ARB group in SBP and UAER (P0．O1)．Conclusion Treatment of ACEI combined with ARB can dually block Renin—Angiotensin System，and stro