西拉普利延缓糖尿病慢性肾功能衰竭发展的临床观察

目的观察西拉普利降低糖尿病肾病患者的血压、蛋白尿,延缓轻度慢性肾功能衰竭(CRF)进展的作用。方法经WHO标准确诊的2型糖尿病轻度肾功能不全(Scr134～254μmol/L或Ccr46～60mlmin)患者81例,随机分为西拉普利治疗组(41例)和心痛定对照组(40例)。所有高血压患者用上述降压药维持正常血压,随访期6个月。结果治疗组治疗后收缩压平均下降11.1mmHg、舒张压平均下降11mmHg、尿蛋白平均下降49%,均较治疗前明显下降(P<0.01),Ccr明显增加;对照组治疗后收缩压、Cc明显下降,Scr、尿素氮明显增加,但舒张压和尿蛋白无明显差异,两组相比,治疗组降低血压、蛋白尿和延缓CRF进展的作用明显优于对照组。结论西拉普利具有良好的降血压和减少蛋白尿的作用,能明显延缓轻度糖尿病慢性肾功能衰竭的进展,对糖尿病慢性肾衰患者具有显著的肾保护作用。

Effect of the angiotensin-converting-enzyme inhibitor Cilazapril on the progression of chronic renal failure in DM

Objective To determine the effect of the angiotensin-converting-enzyme inhibitor Cilazapril on the progression of chronic renal failure(CRF)in the patients with diabetes mellitus(DM).Methods In six months trial involving81patients with mild renal failure(Ccr46-60ml/min or Scr134-254μmol/L)caused by DM,41patients received Cilazapril and40received Nifedipine radomly.Results At six months,patients in the Cilazapril group had been lowed systolic and diastolic blood pressure(on the average,13.1mmHg,11mmHg,respectively),and urinary protein excretion(on the average decreased49%),and slowed progression rate of renal failure than that in the Nifedipine group.Conclusion Cilazapril can significantly reduce blood pressure and urinary protein excretion.It provides protection against the progression of renal failure in the patients with diabetic nephropathy.