依那普利对糖尿病者肾血流动力学及尿白蛋白的影响

Effect of enalapril on renal hemodynamics and microalbuminuria in diabetic patients

本文比较了２８例老年糖尿病合并微白蛋白尿患者服依那普利（ｅｎａｌｐｒｉｌ）４周前后尿微量白蛋白、血及尿β２－微球蛋白、肾小球滤过率（以内生肌酐清除率表示）等变化。结果显示服药后尿微白蛋白排泄减少、内生肌酐清除率下降；将２８例分成正常（尿白蛋白＜２５ｍｇ／２４ｈ）及亚临床微白蛋白尿组（２５～１００ｍｇ／２４ｈ），发现前组服药后尿白蛋白排泄率无变化，而后组明显减少；按内生肌酐清除率将２８例分成正常组（＜１２０ｍｌ／ｍｉｎ）和升高组（＞１２０ｍｌ／ｍｉｎ），发现前组服药后内生肌酐清除率无改变，而后组明显降低。因此依那普利对老年糖尿病伴有尿微白蛋白和（或）内生肌酐清除率升高患者的肾脏有更明显的保护作用。

The renal effects of enalapril treatment for 4～6 weeks were evaluated in 28 aged diabetic patients with microalbuminuria. The results showed that urinary microalbumin excretion(UMAE) and creatinine clearance(CCr) were significantly lowered or improved after enalapril administration( P <0 05).The effects were more significant in those patients with abnormal UMAE and CCr. These results suggest that enalapril exhibits a renoprotective effect, especially in aged diabetic patients with microalbuminuria or high CCr.