螺内酯联合福辛普利对2型糖尿病肾病蛋白尿的影响

目的:探讨螺内酯联合福辛普利治疗2型糖尿病肾病的安全性及其对蛋白尿的影响。方法:60位2型糖尿病肾病患者随机平均分为对照组和治疗组,对照组予福辛普利10mg?d-1治疗,治疗组额外予螺内酯20mg?d-1治疗,实验持续12周,定期测量患者血压、生化指标及24h尿蛋白定量。结果 :与对照组比较,治疗组24h尿蛋白下降更显著(P<0.01),患者没有明显导致肾小球滤过率(GFR)下降、血钾上升及低血压。结论:一定剂量的螺内酯能加强血管紧张素转化酶抑制剂(ACEIs)对糖尿病肾病进程延缓作用。

Effect of Combined Therapy of Spironolatone and Fosinopril on Proteinuria in Patients with Type 2 Diabetic Nephropathy

Objective： To investigate the safety of combined therapy of spironolactone and fosinopril in the treatment of type 2 diabetic nephropathy and its effect on proteinuria. Methods： Sixty patients with type 2 diabetic nephropathy were randomly devided into control group and case group. Patients in the control group received fosinopril （10mg/d） and those in the case group received additional spironolactone （20mg/d） for 12 weeks. Blood pressure, biochemical parameters and 24-h proteinuria were determined for each patient at regular intervals. Results：24-h proteinuria reduced more signiifcantly in the case group compared to the control group （P〈0.01）, the patients did not develop any signiifcant adverse effect including distinct reduction in GFR, hyperkalemia and hypotension. Conclusion： Low to moderate doses of spironolactone can augment the effect of ACEIs in the prevention of diabetic nephropathy.