巯甲丙脯酸对早期NIDDM患者肾血流动力学、前列腺素及尿白蛋白的影响

对２９例血压正常、多次尿蛋白定性阴性的早期ＮＩＤＤＭ患者在用巯甲丙脯酸（ＣＰＴ）治疗２周前、后的肾血流动力学及肾前列腺素的变化进行了观察。结果表明ＮＩＤＤＭ早期存在肾小球滤过率（ＧＦＲ）、滤过分数（ＦＦ）以及肾前列环素（ＰＧＩ２）的增加，ＣＰＹ治疗后，选择性地降低了患者ＧＦＲ、ＦＦ及肾ＰＧＩ２，同时减少了尿微白蛋白的排泄。提示ＣＰＴ对早期糖尿病肾病的防治具有重要意义。

EFFECT OF CAPTOPRIL ON RENAL HEMODYNAMICS AND RENAL PROSTAGLANDINS IN EARLY NORMOTENSIVE NIDDM PATIENTS WITH MICROALBUMINURIA

In this study, we investigated the effect of Captopril (CPT) on glomerular filtration rate(GFR),effective renal@lasma flow(ERPF), filtration fraction(FF) , urinary albumin excretion(UAE)and daily urinary excretion of thromboxane B2 (TXB2)and 6-keto-prostaglandin F1a(6-keto-PGF1a)in 29 NIDDM patients without clinically discernible nephropathy. Before treatment ,urinaryexcretion of 6-keto-PGF1a was significantly increased(P<0.05)in 29 NIDDM as compared with 25 healthy subjects matched for ageand sex. The values of GFR and FF were sig-nificantly higher(P<0.01 and P<0.005, respectively) in NIDDM than those of nor-mal volunteers,whereas ERPF was comparable in both groups. Meanwhile , we observed that UAE of early NIDDM was increasedbefore treatment.After CPT treatment ,GFR, FF , UAE ,and urinary excretion of 6-keto-PGF1a were significantly reduced (P<0.005)as compared with those of NIDDM before treatment, while ERPF urinary excretion of TXB2 was not affected.These re-sults indicate that CPT is effective in lowering the glomerular filtration pressure and ameliorating the microalbuminuria in the nor-motensive early NIDDM, and may reverse or even prevent the development of early diabetic nephropathy by its effect on renalhemodynamics and renal prostaglandins synthesis.