螺内酯与贝那普利联合治疗对早期糖尿病肾病尿白蛋白排泄率的影响

目的观察螺内酯和贝那普利联合应用对早期糖尿病(DM)肾病患者尿白蛋白排泄率(UAER)的影响。方法选取早期糖尿病肾病患者65例,随机分为联合治疗组33例和贝那普利组32例,2组控制血糖方法相同,贝那普利组给予贝那普利10mg,每日1次,联合治疗组加服螺内酯20mg,每日1次。均连续治疗6个月,比较治疗前后2组患者血浆白蛋白(Alb)、尿素氮(BUN)、肌酐(Scr)、肌酐清除率(Ccr)及UAER的变化,观察药物不良反应。结果治疗6个月后,2组UAER均显著降低(P<0.01),且与贝那普利组(81μg/min±30μg/min)相比,联合治疗组UAER(51μg/min±28μg/min)进一步显著降低(P<0.01),其他指标差异无统计学意义(P>0.05),未观察到严重不良反应。结论贝那普利与小剂量螺内酯联用降低早期糖尿病肾病患者的UAER效果更显著,且使用安全。

The effect of combined applying spironolactone with benazepril on urinary albumin excretion rate of early diabetic nephropathy

Objective To observe the effects of combination using of spironlactone with benazepril on urinary albumin excretion rate （UAER） of early diabetic nephropathy.Methods 65 consecutive patients with early diabetic nephropathy were divided into two groups randomly. One is the combination treatment group （33 cases）, with benazepril 10 mg daily and spironolactone 20 mg daily for 6 months, the other benazepril group （32 cases） with benazepril 10 mg daily only. All 65 patients used the same way to control blood sugar. Serum Alb,BUN,Scr,Ccr and UAER of all patients were recorded and compared before and after the treatment. Results After the treatment for 6 months, the UAER of all patients reduced remarkably （ P 〈 0.01 ）, furthermore, the combination group （51 μg/min ＋ 28 μg/min ） had better effect than the benazepril group（81 μg/min ＋ 30 μg/min） （ P 〈 0.01）. Other indexes didn＇t show statistical difference between these two groups （ P 〉 0.05）. No serious adverse events were observed. Conclusion Combined the benazepril with low dose of spironolactone may significantly and safely reduce urinary albumin excretion rate in early diabetic nephropathy.