醛固酮受体拮抗剂对早期糖尿病(2型)肾病的疗效研究

Effects of Aldosteroneantagonist on Early Type2 Diabetic Nephropathy

目的:观察联合应用螺内酯和厄贝沙坦对有持续微量自蛋白尿(MAu)的2型糖尿病患者的肾脏保护作用。方法:69例2型糖尿病伴MAU患者随机分为A组(联合治疗组,厄贝沙坦150mg/d+螺内酯40mg/d)、B组(螺内酯组,40mg/d)、C组(厄贝沙坦组,150mg/d)治疗6个月。结果:治疗后各组尿白蛋白排泄率(uAER)、及尿T转化生长因子-β_1(TGF-β_1)水平明显下降(P<0.01),UAER及TGF-β_1减少幅度各组间对比,联合治疗组最明显(P<0.05);血肌酐(SCr)和尿素氨(BUN)有所下降(P<0.05),其余指标无明显变化。结论:联合应用厄贝沙坦和螺内酯较单独应用这两种药物可更有效地降低2型糖尿病患者的MAU,且其肾脏保护作用安全有效。

Objective： To observe renoprotection effect for kidney of the association of spironolactone and Irbesartan in patients with type2 diabetes and persistent microalbunminuria（MAU）.Methods：69 patients with MAU type2 diabetes were Divided randomly into groupA（group-therapeutic alliance,Irbesartan 150rag/d＋ spironolactone 40mg/d）,groupB（group-spironolactone,40 mg/d）,groupC（group- lrbesartan,150mg/d）,and treated for six month.Results：The urinary albumin excretion rate（UAER）and urineTtransforraing growth factor-β, （TGF-β） of each group descended obviously（P〈0.01）. Compared the decrease of UAER and TGF-β among all groups,the therapeutic alliance group descended the most（P〈0.01）：SCr and BUN also decreased （P〈0.05）：the rest indexes had no remarkble changes. Conclusions：The association of spironolactone and Irbesartan can decrease microalbunminuria in patients with type2 diabetes more than using the two drugs seperately/alone. And the renoprotection effect for kidney is of safety and utility.