血管紧张素转换酶抑制剂对高血压合并糖尿病患者蛋白尿的治疗作用

目的观察血管紧张素转换酶抑制剂福辛普利对高血压合并糖尿病患者蛋白尿的治疗作用。方法将80例高血压合并糖尿病患者随机分为2组，常规治疗组40例，应用苯磺酸氨氯地平5—10mg／d治疗2周，治疗组40例，用苯磺酸氨氯地平5～10mg／d＋福辛普利10～20mg／d治疗2周，观察其血压控制情况及24h尿蛋白情况，并与同等选择条件的常规治疗组作对比观察。结果福辛普利可在降低血压的同时，明显减少24h尿蛋白的排泄。结论血管紧张素转换酶抑制剂能通过降低系统血压和肾内血压改善肾小球内高压、高灌注及高滤过，及改善肾小球滤过膜选择通透性而减少尿蛋白漏出。

The Effects of Angiotensin Converting Enzyme Inhibitor in Reducing Proteinuria of the Patients with the Combination of Hypertension and Diabetes

Objective] To study the effects of Fosinopril （ angiotensin converting enzyme inhibitor l in reducing proteinuria of the patients with the combination of hypertension and diabetes. Methods ] 80 patients with the combination of hypertension and diabetes were divided into two groups randomly：Control group （40 cases } received 5 - 10mg Amlodipine Besylate per day for two weeks. Treatment group （40 cases） received 5 - 10mg Amlodipine Besylate adding on Fosinopril 10 - 20mg per day for two weeks. The difference in the changes of blood pressure and 24h proteinuria between treatment group and control group in the same conditions were observed and analyzed. Results] Fosinopril can reduce 24h proteinuria significantly and decrease blood pressure at the same time. Conclusion] Angiotensin converting enzyme inhibitor can reduce proteinuria by decreasing systemic and nephritic pressure to improve intraglomerular hypertension, hyperperfusion, hyperfiltration and glomerular filtration membrane permeability.