苯那普利联合前列地尔治疗2型糖尿病早期肾病的临床研究

Investigation of the clinical curative effects of benazepril combined with alprostadil on microalbuminuria of early diabetic nephropathy

目的探讨血管紧张素转换酶抑制剂(ACEI)联合苯那普利及前列腺素E1(PGE1)治疗2型糖尿病早期肾病(DN)微量白蛋白尿临床效果。方法将60例临床确诊2型糖尿病(T2DM)早期肾病的患者随机分成治疗组32例和对照组28例,两组的基本治疗是控制饮食和胰岛素皮下注射降血糖。对照组在基本治疗的基础上应用苯那普利,治疗组在基本治疗的基础上联合应用PGE1及苯那普利,疗程均为2周。观察治疗前后两组患者24小时尿微量白蛋白排泄(UAE),血肌酐(SCr),尿素氮(BUN)的变化。结果两组患者治疗前后自身对比,24小时UAE均有显著性下降(P<0.05);与对照组相比,治疗组UAE下降更为明显(P<0.05)。治疗前后血肌酐均无明显的变化(P>0.05)。治疗后对照组BUN明显上升(P<0.05),而治疗组无显著改变(P>0.05)。结论ACEI能降低24小时尿微量白蛋白排泄;在ACEI治疗基础上加用PGE1,降低24小时尿微量白蛋白排泄方面疗效优于前者。

Objective To investigate the effects of benazepril combined with alprostadil on patients with microalbuminuria of early diabetic nephropathy. Methods Sixty patients with microalbuminuria of early diabetic nephropathy were divided randomly into treated group（ n = 32） that were treated with alprestadil combined with benasepril or control group （n =28） that were treated with benaseprll only for two weeks, based on the same basic diet control and insulin. UAE,SCr and BUN of two groups were surveyed before and after treatment. Result After 2 weeks＇treatment, the 24h microalbuminuria decreased significantly in both groups（ P 〈 0.05 ）, but more significantly in the treated group （P 〈 0.05 ）, only the control group showed obvious change in urea nitrogen（ P 〈 0.05） ,and no significant change of the serum creatinine was found in both groups（P 〉 0.05 ）. Conclusion The combination of bonazepril and alprestadil is more effective than benasepril alone.