卡托普利不能阻抑糖皮质激素对肾小球滤过膜通透性的影响

Captopril can not Block the Effects of Steroids on Glomerular Membrane Permeability

目的:观察卡托普利能否抑制肾上腺糖皮质激素(激素)治疗肾病综合征(NS)过程中增加尿蛋白排泄量(UPro)和肾小球滤过膜通透性的作用,了解激素上述作用与肾素-血管紧张素-醛固酮系统的关系。方法:原发性及继发性NS患者分成两组,A组15例观察使用强的松1 mg/kg前后UPro及大、中、小分子蛋白的构成比的变化;B组14例NS,观察使用强的松1 mg/kg及卡托普利50mg前后上述指标的变化。结果:A、B两组用药后UPro及大、中分子蛋白构成比都显著增高,小分子蛋白构成比则显著下降。结论:卡托普利不能阻抑,或不能完全阻抑激素对NS患者UPro及肾小球滤过膜通透性增加的作用;激素上述作用与肾素-血管紧张素-醛固酮系统无关或相关不密切。

The objective of the study was to observe whether the angiotensin-converting enzyme inhibitor capto-pril can block the effects of steroids or not,and to research the relationship between the effects of steroids and the activity of renin-angiotensin-aldosterone system. Method: Fifteen nephrotic patients were enrolled in group A. Urinary protein excretion rate (UPro) and the percentage of low, medium and high molecular proteins were analysed before and after the administration of prednison( 1mg/kg). Fourteen nephrotic patients were enrolled in group B and the same markers were observed before and after the administration of prednison (1mg/kg)and captopril(50mg). Results: The results of both group A and B were the same. When captopril and/or prednison were administered, UPro and high molecular urinary protein were increased significantly, while the low molecular protein was decreased significantly. Conclusion: Captopril can not block the effects of steroids on glomerular membrane permeability. The effects of steroids on glomerular membrane permeability had hardly any relationship with the activity of the renin-angiotensin-aldosterone system of the kidney.