缬沙坦对临床糖尿病肾病的治疗作用

VALSARTAN FOR THE TREATMENT OF CLI NICAL DIABETIC NEPHROPATHY

①目的 观察缬沙坦对临床糖尿病肾病病人尿蛋白排泄量和肾功能的影响。②方法 3 2例临床糖尿病肾病病人在原抗糖尿病治疗的基础上 ,加用缬沙坦 160mg/d治疗 84d ,治疗前后测定病人的血压 ,2 4h尿中的总蛋白、清蛋白、β2 微球蛋白、IgG ,以及血中的尿素氮、肌酐、β2 微球蛋白、血钾、空腹血糖。③结果 治疗 84d后2 4h尿中的总蛋白、清蛋白、β2 微球蛋白及IgG排泄量明显降低 (t=2 .782～ 2 .889,P <0 .0 1) ;收缩压、舒张压及平均动脉压亦明显降低 (t =2 .14 6～ 2 .2 3 4 ,P <0 .0 5 ) ;但尿蛋白排泄量的降低与平均动脉压的变化无相关性 (r =0 .3 5 2 ,P >0 .0 5 )。④结论 缬沙坦可以降低临床糖尿病肾病病人的尿蛋白排泄量 ,从而产生肾脏保护作用 ,其肾脏保护作用除与降压有关外 。

Objective\ To observe the effect of valsar ta n on albuminuria excretion and renal function in patients with diabetic nephrop athy(DN).\ Methods\ 32 cases of clinical DN were given valsartan 160mg once a day for 84 days without changing the preexisting management of diabetes melli tus. The total albuminuria ,urine β 2 MG and urine IgG in urine of 24 hours and blood β 2 MG,Cr, BUN, K + and fasting blood sugar were measured. \ Results\ After 84 days of the treatment,the excretion of total al bumin, albumin,β 2 MG and IgG in 24 hour urine decreased significantly ( t =2.782-2.889, P <0.01) .The systolic and diastolic pressure and mean arterial pressure also dropped significantly (t=2.146-2.234, P <0.05). But the lowerin g of albuminuria was not related to the changes of mean arterial pressure( r=0 .352,P >0.05).\ Conclusion\ Valsartan could reduce the excretion of albuminuria in patients with clinical diabetic nephropathy and thus protect the kidney. Althou gh the renal protection is something to do with the lowering of blood pressure, there are some other mechanisms not dependent upon it.