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目的评估伊那普利治疗糖尿病肾病(DN)的临床疗效 ,并探讨其作用机制。方法40例持续微量蛋白尿的非胰岛素依赖型糖尿病(NIDDM)患者随机分为常规治疗组(n=19)和伊那普利治疗组(n=21)。利用 131I -邻碘马尿酸钠测定有效肾血浆流量(ERPF) ;肾小球滤过率(GFR)以内生肌酐清除率表示 ;通过ELISA法测定尿微量蛋白 ,包括白蛋白(ALB)、转铁蛋白(TF)、视黄醇结合蛋白(RBP)和N -乙酰 - β氨基葡萄糖苷酶(NAG)。结果伊那普利治疗组增高的尿ALB、TF、RBP和NAG均显著下降 ;ERPF显著增加 ;增加的滤过分数(FF)显著减低。而常规治疗组这些参数无显著变化。结论伊那普利具有改善DN患者的肾小球血流动力学 ,保护肾小球和肾小管功能的作用
Objective To evaluate the clinical efficacy of enalapril in the treatment of diabetic nephropathy (DN) and to explore its mechanism. Methods Forty patients with non-insulin-dependent diabetes mellitus (NIDDM) who sustained microalbuminuria were randomly divided into the conventional treatment group (n = 19) and the enalapril treatment group (n = 21). The effective renal plasma flow (ERPF) was measured by 131I-o-iodo-hippurate; the glomerular filtration rate (GFR) was expressed as endogenous creatinine clearance; urine microalbumin, including albumin Protein (TF), retinol binding protein (RBP) and N - acetyl - β - glucosaminidase (NAG). Results The increase of urinary ALB, TF, RBP and NAG were significantly decreased in the enalapril treatment group; ERPF was significantly increased; and the increased filtration fraction (FF) was significantly decreased. The conventional treatment group these parameters no significant change. Conclusion Enalapril can improve the glomerular hemodynamics and protect glomerular and tubular function in DN patients