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目的探讨氯沙坦在早期糖尿病肾病患者降尿微量白蛋白(Alb)的疗效及应用。方法将45例血压正常的早期糖尿病肾病患者随机分为治疗组A组、B组及对照组。两组患者在常规治疗的基础上,治疗组A组每日加用氯沙坦50mg,治疗组B组每日加用氯沙坦100mg。2个月后观察三组治疗前后24 h尿Alb、收缩压(SBP)、舒张压(DBP)、肾功能(BUN、Cr)的变化。结果治疗组24 h尿Alb较治疗前显著下降(P<0.05),与对照组比较差异亦有高度显著性(P<0.05),而治疗组B组较治疗组A组降低更明显;其余各项指标比较差异无显著性。结论早期足量使用氯沙坦具有降低糖尿病肾病患者的24h尿Alb的作用,并且这种作用是通过独立于血压机制实现的。
Objective To investigate the therapeutic effect and its clinical application of losartan on patients with early stage diabetic nephropathy by microalbuminuria (Alb). Methods Forty-five patients with early normotensive diabetic nephropathy were randomly divided into treatment group A, B and control group. Two groups of patients on the basis of conventional treatment, the treatment group A daily plus losartan 50mg, the treatment group B daily plus losartan 100mg. After 2 months, the changes of urinary Alb, SBP, DBP, BUN, Cr in 24 hours before and after treatment were observed. Results Compared with the control group, the urinary Alb level in the 24-hour treatment group decreased significantly (P <0.05), and also significantly higher than that in the control group (P <0.05), while the B group in the treatment group decreased more significantly than the A group in the treatment group. There was no significant difference between the indicators. CONCLUSION Early use of losartan in adequate amounts has the effect of reducing urinary Alb in patients with diabetic nephropathy, and this effect is achieved independently of the blood pressure mechanism.