不同剂量雷米普利对早期糖尿病肾病患者血压及肾功能的影响

Effects of Different Doses of Ramipril on Blood Pressure and Renal Function of Patients with Early Diabetic Nephropathy

目的:比较不同剂量雷米普利对早期糖尿病肾病患者血压及肾功能的影响。方法:选取我院2014年5月-2015年12月收治的早期糖尿病肾病患者108例为研究对象,按照随机数字表法分为A、B、C组,各36例。3组患者均口服雷米普利片治疗,A、B、C组剂量分别为5、2.5、1.25 mg,qd,均治疗8周。比较3组患者治疗前后血压(收缩压、舒张压)和肾功能指标[24 h尿蛋白、β2微球蛋白含量和尿白蛋白排泄率(UAE)],并记录不良反应发生情况。结果:治疗前,3组患者血压、肾功能指标比较,差异均无统计学意义(P>0.05)。治疗后,3组患者血压、24 h尿蛋白含量、β2微球蛋白含量和UAE均显著降低含量,且A组指标显著低于B、C组,差异均有统计学意义(P<0.05);B、C组各项指标比较,差异无统计学意义(P>0.05)。3组患者治疗过程中均有低血压、低血糖等不良反应,但停止治疗后均逐渐好转。结论:大剂量雷米普利(5 mg,qd)治疗早期糖尿病肾病效果较好,能明显降低患者血压,减少患者尿蛋白排泄,且并不影响其安全性。

OBJECTIVE：To compare the effects of different doses of ramipril on blood pressure and renal function of early diabetic nephropathy patients. METHODS：A total of 108 patients with early diabetic nephropathy selected from our hospital during May 2014-Dec. 2015 as research objects were divided into group A,B,C,with 36 cases in each group. All groups were given Ramipril tablets,5 mg for group A,2.5 mg for group B,1.25 mg for group C,qd,for 8 weeks. Blood pressure（SBP,DBP）and renal function indexes（24 h urine protein,β2-microglobulin,UAE） were compared among 3 groups before and after treatment.The occurrence of ADR was also recorded in 3 groups. RESULTS：Before treatment,there was no statistical significance in blood pressure or renal function indexes among 3 groups（P〈0.05）. After treatment,blood pressures 24 h urine protein,β2-microglobulin and UAE of 3 groups were decreased significantly;those indexes of group A were significantly lower than group B and C,with statistical significance（P〈0.05）. There was no statistical significance in each index between group B and C（P〈0.05）. Both hypotension and hypoglycemia occurred in 3 groups during treatment,but were recovered after stopping treatment. CONCLUSIONS：High dose of ramipril（5 mg,qd）shows good effects on early diabetic nephropathy and reduces urinary protein excretion,but doesn＇t affect its safety.