血管紧张素转换酶抑制剂对慢性肾衰患者肾功能保护作用的研究

Effect of the angiotensin converting enzyme inhibitor on the protection of chronic renal insufficiency

目的探讨血管紧张素转换酶抑制剂（ＡＣＥＩ）—洛汀新对各种慢性肾功能不全患者肾功能的保护作用。方法对１１４例慢性肾功能不全患者进行前瞻性分析研究，其中洛汀新治疗组５８例，美多心安对照组５６例，试验的终点定义为肾小球滤过率（ＧＦＲ）降低到基础值的５０％或需要透析治疗时的水平。结果治疗３年治疗组９％患者达到终点，显著低于对照组的２３％（Ｐ＜００５）；治疗组ＧＦＲ减退速率平均为（５８８±３１０）ｍｌ·ｍｉｎ１·ｙｒ１，显著低于对照组的（８６０±３３０）ｍｌ·ｍｉｎ１·ｙｒ１（Ｐ＜００１）。分析显示洛汀新对轻度肾功能不全患者的疗效最好，对肾小球性疾病、糖尿病肾病肾功能具有保护作用，对慢性间质性肾炎、多囊肾、痛风性肾病效果不明显。结论洛汀新对慢性肾功能衰竭患者的肾功能具有保护作用。

Objective\ To determine the effect of the angiotensin-conveting-enzyme inhibitor benazepril on the protection of renal insufficiency in patients with various underlying renal diseases.Method\ [WT5 BZ]We conducted a prospective randomized study in a three-year trial involving 114 patients with renal insufficiency caused by various disorders,58 patients received benazepril and 56 received metoprolol.The end point was a 50% of the base-line glomerular filtration rate (GFR) or the need for dialysis.Result\ At the end of three years,9% patients in the benazepril group and 23% patients in the metoprolol group had reached the end point ( P <0 05).The reduction rate of the GFR was 5 88±3 10ml.min -1 .y r-1 in the benazepril group and 8 60±3 30ml·min -1 .y r-1 in the metoprolol group ( P <0 01).Benazepril was more effective in patients with mild renal insufficiency and could protect the renal function of patients with glomerular diseases,diabetic nephropathy,but not effective in patients with polycystic disease,chronic interstitial nephritis,gouty nephropathy.Conclusion\ Benazepril provides protection against the progression of renal insufficiency in patients with various renal diseases.