培哚普利对糖尿病肾病肾小管功能及尿内皮素的影响

The effects of perindopril on renal function and urinary endothelin excretion in diabetic patients with microalbuminuria

目的观察培哚普利对糖尿病肾病（DN）肾功能及肾脏内皮素（ET）代谢的影响，探讨培哚普利防治DN的机制。方法44例无高血压、持续有微量白蛋白尿的2型糖尿病患者被随机分为培哚普利治疗组和常规治疗组。结果培噪普利治疗8周后DN患者增高的尿白蛋白（A1b）、转铁蛋白（TF）、ET排泄分别减少43．5％、48．1％、36．3％（P＜0．01），而常规治疗无明显变化，相关分析示尿A1b降低和尿ET降低呈正相关（γ＝0．703，P＜0．01）。结论培吸普利对DN肾脏保护作用和其对肾脏局部ET合成的抑制密切相关。

Objective The mechanism of perindopril on diabetic nephropathy was investigated by observing the effects of perindopril on renal function and endothelin (ET) metbolism in diabetic patients with microalbuminuria.Methods Forty-four cases of type 2 diabetes mellitus with microalbuminuria and normotension were randomly divided into two groups: routine group and perindopril group. Results The study lasted 8 weeks, results showed that the elevated urinary albumin (A1b), transferrin (TF) and ET excretion were markedly decreased by 43. 5%, 48. 1% and 36. 3% respectively in perindopril group (P＜0. 01). These parameters had no significant chang throughout the study in routine group. The reduction in urinary ET excretion was strictly related to the decrease in UAE(r = 0. 703, P＜0. 01). Couclusion This study suggested that perindopril might preserve renal function in diabetic nephropathy by inhibiting renal ET production.