糖尿病肾病的尿微量白蛋白监测及药物预防作用的的研究

目的:对Ⅱ型糖尿病患者进行长期尿微量白蛋白监测,观察血管紧张素转换酶抑制剂(ACEI)预防糖尿病肾病(DN)的作用。方法:对象为尿微白蛋白<30mg/24Ⅱ型糖尿病患者。血压正常治疗组27人,给予卡托普利,高血压治疗组15人,在其它抗高血压治疗的基础上加用卡托普利,同时设没有使用卡托普利的对照组病人。每3个月检查一次尿微白蛋白。结果:长达33个月～54个月的观察,血压正常者治疗组有6例(6/27)转为微白蛋白尿,无1例发展为临床白蛋白尿,对照组4例(4/27)转为微白蛋白尿,1例(1/27)转为临床白蛋白尿,P=0.49;高血压治疗组有1例(1/15)转为微蛋白尿,对照组3例(3/15)转为微白蛋白尿,P=0.28。上述治疗组与对照组结果比较均无显著性差异(P>0.05)。结论:ACEI不能阻止糖尿病患者微白蛋白尿形成和不能预防DN的发生。

Study of Preventive Effect of ACEI on Diabetic Nephropathy and Monitoring of Urinary Micro-albumin

To study the preventive effect of an angiotensin-converting enzyme inhibitor (ACEI) on type 2 diabetic nephropathy (DN) using urinary micro-albumin as a marker. Methods: Two groups of type 2 diabetes with urinary micro-albumin<30mg/24h were entered for this study, normal blood pressure given captopril (n= 27) and without captopril served as control (n=27); hypertension treated with anti-hypertension preparations and captopril (n=15), also without captopril served as control (n=15). Urinary micro-albumin were monitored every three months. Results: During the 33-54 months of observation, in normal blood pressure group, 6 cases (6/27) of patients taken captopril developed micro-albuminuria, none developed clinical albuminuria; 4 cases (4/27) of controls developed micro-albuminuria, with one case become clinical albuminuria (p=0.49). In hypertension group, 1 case only (1/15) in captopril treated patients and 3 cases (3/15) of controls developed micro-albuminuria (p=0.28). Conclusion: ACEI might have no preventing effect on developing of DN and micro-albuminuria.