大剂量贝那普利治疗慢性肾病蛋白尿的临床研究

目的观察大剂量贝那普利治疗慢性肾病蛋白尿的，临床疗效及安全性。方法79例慢性肾病患者采用完全随机单盲法分成2组，贝那普利组完成观察35例，对照组完成观察32例，2组患者均给予激素或激素加环磷酰胺，或仅用潘生丁、保肾康等一般治疗。贝那普利组在上述治疗基础上加用贝那普利，开始以10mg／d，1周后加至20mg／d，2周后加至30～40mg／d，分2次口服，疗程24周。结果贝那普利组完全缓解19例，部分缓解10例，部分有效4例，无效2例，总有效率94．3％；对照组完全缓解14例，部分缓解9例，部分有效5例，无效4例，总有效率87．5％，2组有统计学意义（P〈0．05）。贝那普利组治疗前24h尿蛋白定量（2．67±1．32）g，治疗后为（0．67±0．58）g，差异有统计学意义（P〈0．01）；对照组治疗前24h尿蛋白定量（2．74±1．29）g，治疗后为（0．94±0．73）g，差异有统计学意义（P〈0．01）；2组治疗后尿蛋白定量比较差异有统计学意义（P〈0．05）。贝那普利组与对照组血压、血肌酐差异无统计学意义。结论大剂量贝那普利治疗慢性肾病有降低尿蛋白的作用，安全有效。

Prospective random controlled clinic study of high-doses of angiotensin-converting enzyme inhibitor benazapril in patients of chronic kidney diseases with proteinuria

Objective To evaluate the antiproteinuric effect and safety of highdose ACE for hibitor benazapril for patients of chronic kiclney diseases with proteinuria. Methods A prospective random controlled clinical trail was performed. Seventy-nine patients were divided into two groups in this 24-week study (coutrd group 32 cases, trial group 35 patients). These patients were recorded of age, sex, pathogeny, 24 hour unnary protein excretion, serum albumin concentration and serum creatinine concentration (P>0.05). All received cortical hormone,or cortical hormone and CTX, or only dipyridamole and piperazine ferulate.The trial group received extra orally 30～40 mg/d benazapril for 24 weeks. Results In control group, nineteen patients had complete remission, 10 partial remission,4 partial effect and 2 no effect in trial group. In control group, forteen complete remission,9 partial remission,5 partial effect and 4 no effect in control group. Proteinuria decreased significantly from baseline urinay protein excretion of (2.67±1.32)tg/24 h to (0.67±0.58)g/24 h in trial group (P<0.01) . Proteinuria decreased significantly from baseline protein excretion of (2.74±1.29) g/24 h to (0.94±0.73) g/24 h in control group (P<0.01) . The urinay protein excretion was statistically different between trial group and control group (P<0.05). There was no differece between trial group and control group in blood pressure and blood serum creatinine (P<0.05). Conclusion A highdose ACE inhibitor, benazapril can safely reduce proteinuria in patients with chronic kidney diseases.