依那普利防治糖尿病肾病的疗效初探

A Prospective Study of Preventive and Therapeutic Effects of Enalapril on Diabetic Nephropathy

目的 :前瞻性研究依那普利对降低血管紧张素转换酶 (ACE)活性 ,保护糖尿病肾病 (DN)患者的肾功能 ,阻止肾病恶化的疗效。方法 :将62例DN患者按病情、性别、年龄和病程相匹配原则分成两组。治疗组除常规口服降糖药、降压药外 ,每日口服依那普利10mg,对照组仅给予常规治疗 ;两组各31例 ,观察时间为18mo～36mo(平均26mo) ,记录并比较两组患者治疗前、后的血压、血糖及肾功能变化。结果 :治疗组血糖、血压及肾功能情况比治疗前均有显著改善 (P<0.05) ;而对照组除血压外其他项目无显著性变化。治疗组不管是否伴高血压 ,尿白蛋白排泄率 (UAER)均显著减少 (P<0.05),而对照组仅伴高血压者UAER有减少 ,但无统计学意义 (P>0.05)。结论 :依那普利能确切降低ACE活性 ,对DN患者的肾功能有保护作用 。

OBJECTIVE:To prospectively investigate the effects of enalapril in decreasing ACE activity,renal function protection in diabetic nephropathy(DN)patients and prevention of deterioration from DN METHODS:62 DN patients were divided into two groups,31 in each group,the sex,age,disease duration and condition were comparable In treatment group,patients received enalapril 10mg/d in addition to routine anti-hyperglycemic and anti-hypertensive agents,in control group,patients had only routine treatment The observation lasted 18～36 months(mean 26 months) The BP,blood sugar and renal functions were compared between two groups before and after treatment RESULTS:In treatment group,blood sugar,BP and renal functions were significantly improved after treatment of enalapril(P<0 05),however,in control group,only BP was improved,the changes of other parameters did not reach significant levels In treatment group,the UAER of patients with or without hypertension was significantly lowered after treatment(P<0 05),however,in control group,the UAER was lowered only in hypertensive patients but did not reach significant level(P>0 05) CONCLUSION:Enalapril can lower ACE activity and protect the renal function,these effects do not depend on it's anti-hypertension result