安体舒通对1型糖尿病肾病患者尿微量白蛋白的影响被引量：2

Effects of sprionolactone on urinary microalbumin in patients with type 1 diabetic nephropathy

下载PDF

导出

摘要目的观察安体舒通对1型糖尿病患者尿微量白蛋白的影响。方法将我院42例早期1型糖尿病肾病患者随机分为对照组(23例)和安体舒通治疗组(19例),对照组采用常规治疗,治疗组在常规治疗的基础上加用安体舒通(20 mg/d,qd),两组疗程均为12周。检测患者治疗前后尿微量白蛋白排泄率(UAER)、血肌酐(Scr)等,记录患者不良反应。结果对照组随着基础治疗时间的延长,8周末UAER[(59.92±2.01)μg/min]与治疗前[(101.75±1.98)μg/min]比较明显降低(P<0.05)。安体舒通治疗组8周治疗后UAER[(21.92±1.52)μg/min]与治疗前[(104.07±2.06)μg/min]比较显著减少(P<0.01);其与对照组比较差异仍有统计学意义(P<0.05)。安体舒通治疗组和对照组患者Scr水平治疗前后差异无统计学意义(P>0.05),且无不良反应。结论在常规治疗糖尿病肾病的基础上加用安体舒通能进一步降低UAER,延缓肾脏损伤,对肾功能起到保护作用。 Objective To observe the effect of sprionolactone on urinary microalbumin in patients with type 1 diabetic nephropathy.Methods Forty-two patients with diabetic nephropathy were randomly divided into two groups.The control group （n=23） received conventional treatment,while sprionolactone treatment group （n=19） was given 20 mg/d sprionolactone （qd） based on conventional treatment.The treatment course was 8 weeks.The levels of urinary albumin excretive rate （UAER）,Scr and adverse drug reactions of the two groups were observed.Results In the control group,the UAER after treatment [（59.92±2.01） μg/min] was significantly reduced,compared with that before treatment [（101.75±1.98） μg/min,P＜0.05.The UAER in sprionolactone treatment group was lowered more significantly after treatment [（21.92±1.52） μg/min vs （104.07±2.06） μg/min; P＜0.01],showing statistically significant difference with the control group [（21.92± 1.52） μg/min vs （59.92±2.01） μg/min; P＜0.05].The Scr level of the control group and sprionolactone treatment group showed no significant difference before and after treatment （P＞0.05）,and no adverse reactions were found.Conclusion Spironolactone based on conventional treatments can offer additional renoprotection in patients with diabetic nephropathy,further reduce the urinary albumin excretive rate,and protect the kidney function.

作者韩立坤孙洪涛孙娜娜

机构地区内蒙古民族大学附属医院内分泌科

出处《海南医学》 CAS 2014年第2期208-210,共3页 Hainan Medical Journal

关键词 1型糖尿病糖尿病肾病安体舒通尿微量白蛋白 Type 1 diabetes mellitus Diabetic nephropathy Sprionolactone Urinary microalbumin

分类号 R587.2 [医药卫生—内分泌]

引文网络
相关文献

参考文献13

1Cao Z,Bonnet F,Dav is B. Additive hypotensive and anti-album inuric effects of angiotensin-converting enzyme inhibition and angiotensin receptor antagonism in diabetic spontaneously hypertensive rats[J].{H}CLINICAL SCIENCE,2001,(6):591-599.
2张露,刘必成.血管紧张素Ⅱ与肾脏血管结构重塑[J].国外医学（泌尿系统分册）,2004,24(6):841-844. 被引量：5
3Gurley SB,Coffm an TM. The renin-angiotensin system and diabetic nephropathy[J].Sem in Nephrol,2007,(2):144-152.
4Struthers AD,MacDonald TM. Review of aldosterone and angiotensin Ⅱ-induced target organ damage and prevention[J].{H}Cardiovascular Research,2004,(4):663-670.
5Takebayashi K,Matsumoto S,Aso Y. Aldosterone blockade attenuates urinary monocyte chemo attractant protein-1 and oxidative stress in patients with type 2 diabetes complicated by diabetic nephropathy[J].{H}Journal of Clinical Endocrinology and Metabolism,2006.2214-2217.
6Mogensen CE,Christensen CK,Vitinghus E. The stages in diabetic renal disease with emphasis on the incipient diabetic nephropathy[J].{H}DIABETES,1983,(suppl 2):64.
7Andersen AK,Christiansen JS. Diabetic nephropathy in Type 1 (inslin-dependent) diabetes:an epidemiological study[J].Diabetelogia,1983.946.
8Struthers AD,MacDonald TM. Review of aldosterone-and angiotensin Ⅱ-induced target organ damage and prevention[J].{H}Cardiovascular Research,2004,(4):663-670.
9Sechi LA,Novello M,Lapenna R. Long term renal outcomes in patients with primary aldosteronism[J].{H}JAMA:the Journal of the American Medical Association,2006.2638-2645.
10Gurley SB,Coffm an TM. The renin-angiotensin system and diabetic nephropathy[J].Sem in Nephrol,2007,(2):144-152.

二级参考文献23

1Kang DH, Johnson RJ.vascular endothelial growth factor: A new play in the pathogenesis of renal fibrosis .Curr Opin Nephrol Hypertens,2003, 12:43-49.
2Meguid A,Nahas EL.Plasticity of kidney cells:Role of kidney remoldelingand scarring .Kidney Int,2003,64: 1553 - 1563.
3Kitamura H,Shimizu A,Yamanaka N,et al .Apoptosis in glomerular endothelial cells during the development of glomerulosclerosis in the remnant kidney model .Exp Nephrol1,1998,6:328- 336.
4Kand DH,anderson S,Kim YG,et al.impaired angiogenesis in aging kidney:potential role of VEGF and TSP- 1 in renal disease.Am J Kid Dis,2001,37:607 -611.
5Kang DH,Joly AH,Ohsw,et al.Impaired angioginesis in the remnant kidney model(1): potential role VEGF and TSP- 1.J Am Soc Nephrol,2001,12:1434 - 1447.
6Choi YJ, Chakraborty S. Peritubular capillary loss is associated with chronic tubulointerstitial injury in human kidney. altered expression of vascular endothelial growth factor. Hum Pathol,2000,31:1491 - 1497.
7Ohashi R, Kitamura H, Yamanaka N. Peritular capillary injury during the progrossion of experimental glomerulonephritis in rats. J Am Soc Nephrol,2000,11:47- 56.
8Pillebart E, Burtin M, Yuan HT, et al. Proliferration and remodeling of the peritubular microcirculation after nephron redution association with the progression of renal lesions. Am J Pathol,2001,159:547- 560.
9Kang DH, Nakagawa T, et al. Nitric oxide modulares vascular disease in the remnant kidney model. Am J Pathol,2002,161:139 - 248.
10Okamoto K,Kato S,Arima N,et al. Cyclin- dipendent kinase inhibitor,P21wafl,regulates vascular smooth muscle cell hypertrophy. Hypertens Res,2004,27(4) :283 - 91.