依那普利与厄贝沙坦对系膜增生性肾炎的疗效观察

Curative Effect Observation on Enalapril and Irbesartan to Treat Mesangial Proliferative Nephritis

目的观察依那普利和厄贝沙坦对治疗系膜增生性肾炎患者蛋白尿、血尿的有效性和安全性.方法诊断系膜增生性肾炎共40例,其中,选自2001～2003年20例,男11例,女9例.年龄10～44岁.未使用ACEI(血管紧张素转换酶抑制剂)、ARB(血管紧张素转换酶受体拮抗剂)为对照组.选自2004-06～2005-01 20例,男12例,女8例.年龄13～48岁.使用依那普利2.5～10 mg,2次/d+厄贝沙坦150 mg/d.治疗过程中检测24 h尿蛋白定量、尿沉渣红细胞计数,血肌酐、血钾、24 h尿量,并记录血压及不良反应.结果用依那普利+厄贝沙坦组24 h尿蛋白治疗0、4、6、8周分别为(2.14±0.78)g/d、(0.76±0.43)g/d,(0.49±0.30)g/d,(0.51±0.31)g/d;对照组分别为(2.01±0.67)g/d,(1.43±0.76)g/d,(0.78±0.58)g/d,(0.72±0.56)g/d,用依那普利+厄贝沙坦组尿沉渣红细胞计数0、4、6、8周分别为(454±189)万/mL,(85±57)万/mL,(26±14)万/mL,(23±11)万/mL,对照组分别为(370±175)万/mL,(136±53)万/mL,(49±22)万/mL,(35±23)万/mL.2例服用依那普利出现干咳,无低血压、高血钾、尿量减少、肾功能恶化发生.结论依那普利+厄贝沙坦减少尿蛋白、血尿快于对照组,疗效好,对血压影响不大,副作用轻,安全性好.

Objective To observe the efficacy and safety of enalapril and irbesartan to treat the mesangial proliferative nephritis （MPN） in proteinuria and hematuria. Methods 40 cases of such patient obtained pathological diagnosis were observed from 2001 to 2005.20 cases were as control group treated without ACEI and ARB; 20 cases were used enalapril of 5 - 10 mg twice a day and irbesartan 150 mg per day as therapy group. The lab test of urine protein, urinary sediment, serum creatinine, potassium and blood pressure and side effects were observed. Results The urine protein within 24 hour in therapy group was （2.14 ± 0.78）g/d, （0.76 ± 0.43）g/d, （0.49 ± 0.03）g/d, （0.51 ± 0.31）g/d; and in control group（2.01 ± 0.67） g/d, （ 1.43 ± 0.76） g/d, （0.78 ± 0.58） g/d, （0.72 ± 0.56） g/d in 0, 4, 6, and 8 weeks. The urinary sediment in therapy group in 0,4,6,8 weeks was（454 ± 189） 10^5/mL, （85 ± 57） 10^5/mL, （26 ± 14） 10^5/mL, （23 ± 11 ）10^5/mL, and in control group was （370 ± 175） 10^5/mL, （ 136 ± 53） 10^5/mL, （49 ± 22） 10^5/mL, （35 ± 23 ） 10^5/ mL. 2 cases with enalapril had no side effect but only cough. Conclusion The combination use of enalapril and irbesartan might have better curative effect than those in control group with good efficacy and safety.