替米沙坦对糖尿病肾病患者尿nephrin排泄的影响

目的 探讨糖尿病肾病（diabetic nephropathy,DN）患者尿nephrin排泄的变化及替米沙坦干预对其的影响.方法 62例DN患者经2周洗脱期后给予替米沙坦40 mg/d＆#215;4周,继以替米沙坦80 mg/d＆#215;4周.另有20例健康志愿者作为正常对照组.采用ELISA法检测尿nephrin蛋白.结果 正常对照组尿液中未检测到nephrin,DN患者组尿液中可检测到nephrn排泄,随DN病情的进展,大量白蛋白尿组比微量白蛋白尿组尿nephrin排泄增加.经替米沙坦治疗后,微量白蛋白尿组患者尿nephrin下降较为明显,大量自蛋白尿组患者治疗前后尿nePhrin 变化无统计学意义.结论 尿nephrin检测可预测DN肾病病情进展,替米沙坦可减少尿nephrin排泄,具有肾脏保护作用.

Effects of telmisartan on urinary nephrin excretion in diabetic nephropathy patients

Objective To investigate the change of urinary nephrin excretion and the effect of telmisartan on urinary neph- rin excretion in DN patients. Methods After two-week washout,62 DN patients received 40 mg/d telmisartan for 4 weeks followed by 80 mg/d telmisartan for an additional 4 weeks. 20 healthy volunteers were served as control. Nephrin was de- tected by ELISA. Results Urinary nephrin couldn＇ t be detected in NC group individuals, urinary nephrin excretion could be detected in DN patients, and with the progress of DN, macroalbuminuria group patients with more urinary nephrin ex- cretion than microalbuminuria group patients. With the treatment of telmisartan, urinary nephrin excretion was obviously decreased in microalbuminuria group patients, but there were no statistical significance in macroalbuminuria group pa- tients. Conclusion In DN patients,urinary nephrin detection could be used to predict the progression of DN. Telmisartan could reduce the urinary nephrin excretion and provide some renal protection in DN.