缬沙坦治疗糖尿病肾病的疗效观察

Effect of Valsartan on Diabetic Nephropathy

目的:观察血管紧张素Ⅱ,Ⅰ型受体拮抗剂(AT1Ra)缬沙坦(Valsartan)对伴大量白蛋白尿的临床糖尿病肾病的治疗作用。方法:32例2型糖尿病患者,24h尿白蛋白排泄率(24hUAER)>200μg/min,均伴高血压,维持原糖尿病治疗不变,分组比较应用缬沙坦(80mg/d)或贝那普利(10mg/d)治疗8周前后平均动脉压(MAP)、24hUAER、HbA1c、尿酸(UA)等指标的变化。结果:缬沙坦治疗组和贝那普利治疗组24hUAER分别由703.2±987.9μg/min降至664.2±970.6μg/min(P<0.01)和由778.6±1005.0降至734.9±996.0μg/min(P<0.01)。二者疗效相似,且均与血压变化不相关。结论:AT1Ra缬沙坦可以降低临床糖尿病肾病的蛋白尿,其肾脏保护作用除了与降血压有关,还有不依赖降压效应的其他机制。

Objective：To survey the effect of angiotensin Ⅱ type Ⅰ receptor antagonists （AT1Ra） valsartan on diabetic nephropathy representing a great quantity of albuminuria. Methods：32 cases of diabetic in type 2 with hypertension and 24 urine albumine excretion rate （24h UAER） more than 200μg/min were selected and divided into two groups, Their conventional therapy for diabetes was maintained. The mean arterial pressure （MAP）, 24h UAER,HbA1c and vric acid before and 8 weeks after administrating valsartan in dosage of 80 mg daily or benazeprin in dosage of 10mg daily were observed. Results： The 24h UAER decreased from 703.2± 987.9 to 664.2 ± 970.6μg/min in group with valsartan （P〈0.01）,778.6 ± 1005.0 to 734.9 ± 996.0μg/min in group with benazeprin （P〈 0.01 ）. The curative effect of valsartan was similar to that of benazeplin,which was not associated with the change of blood pressure. Conelusion ： Valsartan can reduce albuminuria in diabetic nephropathy, it＇s protection in kidney includes other mechanisms besides underpressure.