贝那普利联合丹参、螺内酯对Ⅳ期糖尿病肾病患者肾功能影响

目的探讨贝那普利联合丹参注射液、螺内酯对Ⅳ期糖尿病肾病患者肾功能影响。方法Ⅳ期糖尿病肾病患者80例,随机分为4组,即对照组,贝那普利组（A组）、贝那普利联合丹参注射液组（B组）、贝那普利联合丹参注射液及螺内酯组（C组）;各组均每日口服双氢克尿噻片25 mg,共治疗4周,治疗前、后均测定血压、血糖、糖化血红蛋白、血肌酐（serum creatinine,Scr）、尿蛋白及肾小球滤过率（glomerular filtration rate,GFR）。结果治疗前Scr、尿蛋白、血压、GFR 4组比较无显著性差异（P〉0.05）,治疗后Scr、尿蛋白A、B、C组与对照组比较明显下降（P〈0.01）,GFR明显升高（P〈0.05）;治疗后Scr、尿蛋白B组与A组比较明显下降（P〈0.05）,而GFR明显升高（P〈0.05）。C组治疗后Scr、尿蛋白及血压较治疗前显著下降（P〈0.01）,GFR明显升高（P〈0.01）;C组治疗后的Scr、尿蛋白、血压与A组比较,明显下降（P〈0.01）,而GFR明显升高（P〈0.01）;C组与B组比较,治疗后的Scr、尿蛋白显著降低（P〈0.05）,GFR显著升高（P〈0.05）。结论贝那普利联合丹参注射液、螺内酯治疗Ⅳ期糖尿病肾病患者可明显提高其GFR,降低其尿蛋白和Scr,为治疗Ⅳ期糖尿病肾病提供了新的方案。

Effect of Combination of Benazepril, Salvia Miltiorrhiza and Spironolactone on Glomerular Filtration Rate in Patients with Diabetic Nephropathy

OBJECTIVE To illustrate the effect of combination of benazepril, spironolactone and Salvia miltiorrhiza on glomerular filtration rate in patients with diabetic nephropathy. METHODS Eighty patients with diabetic nephropathy were randomly divided into 4 groups: control group, group A(benazepril group), group B(benazepril + Salvia miltiorrhiza group), group C (benazepril+spironolactone+Salvia miltiorrhiza group). All patients were treated with hydrochlorothiazide(25 mg·d-1) orally for 4 weeks respectively. Renal histology was examined and blood pressure, plasma glucose, HbAlc, serum creatinine(Scr), urine protein and glomerular filtration rate(GFR) were measured respectively before and after treatment. RESULTS At the initial levels of blood pressure, urine protein, Scr and GFR did not show significant change in 4 groups. After 4 weeks, the levels of urine protein and Scr were much lower in group A, B and C(P<0.01) and the levels of GFR was significantly higher(P<0.05) than control group. The levels of blood pressure, urine protein and Scr were much lower and the level of GFR after treatment was higher in group B than group A. The levels of blood pressure, urine protein and Scr were decreased(P<0.01) and the levels of GFR was increased(P<0.05) compared to the levels before treatment in groups C. The levels of blood pressure, urine protein and Scr were much lower and the level of GFR after treatment was higher in group C than in group A(P<0.01). After the treatment, the levels of urine protein and Scr were much lower in group C than group B(P<0.05), and the levels of GFR were significantly higher(P<0.05). CONCLUSION Combination of benazepril, spironolactone and Salvia miltrirrhiza could enhance GFR, decrease urine protein and Scr in the patients with diabetic nephropathy and protect kidney function.