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目的 观察培哚普利对血压正常的早期糖尿病肾病患者的白蛋白尿的疗效和对肾功能的保护作用。方法 糖尿病患者 5 2例 ,其尿白蛋白排泄率 (AER)均在 2 0～ 2 0 0 μg/min之间 ,所有患者经控制饮食、口服降糖药物及 (或 )采用胰岛素治疗使血糖控制在可接受水平 (尚可 ,即空腹血糖 <7 0mmol/L ,餐后 2h血糖 <10 0mmol/L) ,随机分成两组 ,A组为对照组 ,2 5例 ,在控制血糖基础上加用安慰剂治疗 ;B组为治疗组 ,2 7例 ,在控制血糖基础上加用培哚普利治疗。培哚普利剂量为 4mg/d。两组患者在治疗前及治疗后 3、6、12、18个月复查空腹血糖 (FBG)、餐后 2h血糖 (PBG)、糖化血红蛋白A1C(HbA1C)和AER等。结果 A组在 12、18个月时AER分别为 (5 2 3± 8 6 ) μg/min和 (6 0 5± 9 0 )μg/min ,二者与治疗前的 (4 4 2± 6 8) μg/min相比有显著升高 (P <0 0 5 )。B组用培哚普利治疗后 3、6、12、18个月时AER分别为 (2 0 3± 5 6 ) μg/min、(2 2 1± 6 1) μg/min、(2 1 3± 5 9) μg/min和 (2 0 8± 5 7)μg/min ,均明显低于同期A组水平 (P值均 <0 0 5 ) ,与治疗前的 (4 5 3± 7 6 ) μg/min相比 ,差异亦有显著性 (P值均 <0 0 5 )。结论 培哚普利对血压正常的伴有微量白蛋白尿的早期糖尿病肾病患者?
Objective To observe the effect of perindopril on albuminuria in patients with normotensive early diabetic nephropathy and its protective effect on renal function. Methods A total of 52 patients with diabetes mellitus (DM) were enrolled in this study. Their urinary albumin excretion rates (AER) ranged from 20 to 200 μg / min. All patients underwent controlled diet, oral hypoglycemic agents and / or insulin therapy. The patients were divided into two groups randomly at an acceptable level (still, fasting blood glucose <70 mmol / L and postprandial blood glucose <10 0 mmol / L). Group A was control group, 25 cases were treated with glycemic control Placebo treatment; B group for the treatment group, 27 cases, in addition to the control of blood glucose plus perindopril treatment. The perindopril dose was 4 mg / d. Fasting blood glucose (FBG), 2h postprandial blood glucose (PBG), glycosylated hemoglobin A1C (HbA1C) and AER were observed in both groups before treatment, 3,6,12,18 months after treatment. Results The AER of group A was (523 ± 8 6) μg / min and (6 0 5 ± 90) μg / min respectively at 12 and 18 months, both of which were significantly lower than those before treatment (442 ± 68 ) μg / min (P <0 05). The AER of group B at 3, 6, 12 and 18 months after treatment with perindopril were (20 3 ± 5 6) μg / min, (2 2 1 ± 6 1) μg / min, (2 1 3 ± 5 9) μg / min and (2 0 8 ± 5 7) μg / min, respectively, were significantly lower than those of group A (P <0.05) μg / min compared to the difference was also significant (P value <0 0 5). Conclusion Perindopril in patients with normotensive diabetic nephropathy with microalbuminuria?