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目的观察西拉普利降低糖尿病肾病患者的血压、蛋白尿,延缓轻度慢性肾功能衰竭(CRF)进展的作用。方法经WHO标准确诊的2型糖尿病轻度肾功能不全(Scr134～254μmol/L或Ccr46～60mlmin)患者81例,随机分为西拉普利治疗组(41例)和心痛定对照组(40例)。所有高血压患者用上述降压药维持正常血压,随访期6个月。结果治疗组治疗后收缩压平均下降11.1mmHg、舒张压平均下降11mmHg、尿蛋白平均下降49%,均较治疗前明显下降(P<0.01),Ccr明显增加;对照组治疗后收缩压、Cc明显下降,Scr、尿素氮明显增加,但舒张压和尿蛋白无明显差异,两组相比,治疗组降低血压、蛋白尿和延缓CRF进展的作用明显优于对照组。结论西拉普利具有良好的降血压和减少蛋白尿的作用,能明显延缓轻度糖尿病慢性肾功能衰竭的进展,对糖尿病慢性肾衰患者具有显著的肾保护作用。
Objective To investigate the effects of cilazapril on blood pressure and proteinuria in patients with diabetic nephropathy and to delay the progression of mild chronic renal failure (CRF). Methods Eighty-one patients with type 2 diabetes mellitus with mild renal insufficiency (Scr134 ~ 254μmol / L or Ccr46 ~ 60mlmin) were randomly divided into cilazapril treatment group (41 cases) and xintongding control group (40 cases ). All hypertensive patients with the antihypertensive drugs to maintain normal blood pressure, follow-up period of 6 months. Results After treatment, systolic blood pressure decreased by 11.1 mmHg, diastolic blood pressure decreased by 11 mmHg, and urinary protein decreased by 49% on average in the treatment group, which were significantly lower than those before treatment (P <0.01). Ccr was significantly increased in the treatment group. Systolic blood pressure Decreased, Scr, urea nitrogen increased significantly, but diastolic blood pressure and urinary protein no significant difference between the two groups, the treatment group lower blood pressure, proteinuria and delay the progress of CRF was significantly better than the control group. Conclusion Cilazapril has a good antihypertensive and anti-proteinuria effect, can significantly delay the progression of mild diabetic chronic renal failure, has a significant renal protection in patients with chronic renal failure.