【摘要】 目的　探讨依那普利对伴有重度肾功能不全的慢性肾小球肾炎患者的有效性和安全性。方法　慢性肾小球肾炎患者 4 6例 ,以内生肌酐清除率 (Ccr)分为两组。高Ccr组 :Ccr 5 0ml·min- 1以上 ,13例 ;中Ccr组 :Ccr 2 5～ 5 0ml·min- 1,17例 ;低Ccr组 :Ccr2 5ml·min- 1以下 ,16例。临床观察 2mon后 ,依那普利治疗 4mon ,停药后再观察 2mon。每月动态检测尿蛋白、尿白蛋白清除率、肾功能及血清钾等指标。结果　与高、中Ccr组相比 ,依那普利在低Ccr组抗蛋白尿作用较小 ,且血清钾轻度升高 ;治疗后 3组Ccr均降低 ,而停药后低Ccr组不恢复 ,但无进行性降低。结论　依那普利对伴有重度肾功能不全的慢性肾小球肾炎患者仍具有抗蛋白尿作用 ,且较为安全。更多还原

【Abstract】 Aim To evaluate the therapeutic effectiveness and safety of enalapril in patients of chronic glomerulonephritis with severe renal failure. Methods Forty-six patients with chronic glomerulonephritis were divided into three groups according to their creatinine clearance?rate (Ccr) including?13?cases?with?Ccr?more?than? 50 ml·min -1?in?high?Ccr group, 17 cases with Ccr more than 25 ml·min -1 and less than 50 ml·min -1 in mid Ccr group and 16 cases with Ccr less than 25 ml·min -1 in low Ccr group. All patients were observed 2 mon before the 4 mon of enalapril treatment. The evaluation of efficiency was concluded in the following 2 mon. Urinary protein and albumin clearance rate, renal function and serum potassium were measured every month. Results [WTBZ紼nalapril could reduce urinary protein in high and mid Ccr group more effectively than in low Ccr group. Ccr in high and mid Ccr group was recovered soon but not in low Ccr group since all the patients’ Ccr decreased by enalapril. Furthermore, serum potassium in low Ccr group grew slightly. [WTHZ]Conclusion Enalapril can safely decrease the urinary protein in patients of chronic glomerulonephritis with severe renal failure.更多还原