【摘要】 目的　观察培哚普利对血压正常的早期糖尿病肾病患者的白蛋白尿的疗效和对肾功能的保护作用。方法　糖尿病患者 5 2例 ,其尿白蛋白排泄率 (AER)均在 2 0～ 2 0 0 μg/min之间 ,所有患者经控制饮食、口服降糖药物及 (或 )采用胰岛素治疗使血糖控制在可接受水平 (尚可 ,即空腹血糖 <7 0mmol/L ,餐后 2h血糖 <10 0mmol/L) ,随机分成两组 ,A组为对照组 ,2 5例 ,在控制血糖基础上加用安慰剂治疗 ;B组为治疗组 ,2 7例 ,在控制血糖基础上加用培哚普利治疗。培哚普利剂量为 4mg/d。两组患者在治疗前及治疗后 3、6、12、18个月复查空腹血糖 (FBG)、餐后 2h血糖 (PBG)、糖化血红蛋白A1C(HbA1C)和AER等。结果　A组在 12、18个月时AER分别为 (5 2 3± 8 6 ) μg/min和 (6 0 5± 9 0 )μg/min ,二者与治疗前的 (4 4 2± 6 8) μg/min相比有显著升高 (P <0 0 5 )。B组用培哚普利治疗后 3、6、12、18个月时AER分别为 (2 0 3± 5 6 ) μg/min、(2 2 1± 6 1) μg/min、(2 1 3± 5 9) μg/min和 (2 0 8± 5 7)μg/min ,均明显低于同期A组水平 (P值均 <0 0 5 ) ,与治疗前的 (4 5 3± 7 6 ) μg/min相比 ,差异亦有显著性 (P值均 <0 0 5 )。结论　培哚普利对血压正常的伴有微量白蛋白尿的早期糖尿病肾病患者?更多还原

【Abstract】 Objective To study the effect of perindopril in decreasing the urinary albumin execretion rate (AER) and protecting the renal function in normotensive early diabetic nephropathy. Methods 52 diabetic patients with AER between 20 to 200 μg/min, were treated with dietary regimen, oral antihyperglycemic agents or/and insulin till their fasting blood glucose (FBG) was <7.0 mmol/L and postprandial blood glucose (PBG)<10.0 mmol/L. They were then divided randomly into two groups. Group A was a control group (25 cases), the patients were administered with placebo, group B was a treatment group (27 cases), the patients were administered with perindopril (4 mg/day) FBG, PBG, glycosylated heamoglobin A 1C(HbA 1C)?AER?blood pressure (MAP) and blood creatinine (Cr) were examined immediately and 3, 6, 12 and 18 months after the treatment. Results In group A, AER was significantly increased affter 12 and 18 months than at beginning, they were(52.3±8.6) μg/min and (60.4±9.0) μg/min vs (44.2±6.8) μg/min ( P<0.05). In group B, after being treated with perindopril, AER estimated 3, 6, 12 and 18 months later were (20.3±5.6) μg/min, (22.1±6.1) μg/min, (21.3±5.9) μg/min and (20.8±5.7) μg/min respectively, all were significantly lower those that of group A in the same period (P<0.05) and also significantly lower than those at the beginning (P<0.05). Conclusion Perindopril has good effects in decreasing AER in normotensive early diabetic nephropathy and in protecting the renal function.更多还原