培哚普利对糖尿病肾病患者白蛋白、转铁蛋白及尿内皮素-1含量的影响

目的 观察培哚普利对早期糖尿病肾病(DN)肾小球功能及肾脏内皮素(ET)代谢的影响，探讨培哚普利防治DN的机制。方法 44例无高血压、持续有微量白蛋白尿的Ⅱ型糖尿病患者被随机分为培哚普利治疗组和常规治疗组。结果 培哚普利治疗8周后DN患者的尿白蛋白(Alb)、转铁蛋白(TF)、ET排泄分别减少43.5%、48.1%、36.3%(P<0.01)，而常规治疗无明显变化，相关分析示尿Alb降低和尿ET降低呈正相关(r=0.703,P<0.01)。结论 培哚普利改变DN肾小球功能和其对肾脏局部ET合成的抑制密切相关。

Effects of perindopril on urinary albumin, transferrin and endothelin levels in diabetic patients with microalbuminuria

Objective To investigate the effects of perindopril on renalglomerular function and renal endothelin (ET) metbolism in diabetic patients with microalbuminuria for the mechanism of perindopril on diabetic nephropathy (DN). Methods Forty-four cases of non-insulin-dependent diabetes mellitus with microalbuminuria and normotension were randomly divided into 2 groups: routine group and perindopril group. A total of 15 healthy individuals were collected as normal control without any treatment. The levels of urinary albumin(Alb)、transferrin (TF) and ET in urine and blood were determined respectively after the 8-month treatment. Results In perindopril group, the urinary Alb, TF and ET excretion were markedly decreased by 43.5%, 48.1% and 36.3% respectively compared with those before the treatment (P<0.01). While, no significant change was found in these indices in routine group. The decline of urinary ET excretion had a positive correlation to the decrease of urinary Alb (r=0.703,P<0.01). Conclusion This study suggested that perindopril might preserve renal glomerular function in diabetic nephropathy by inhibting renal ET production.