论文部分内容阅读
目的探讨依那普利对肾脏保护作用的机制。方法在观察３２名ＮＩＤＤＭ、１３名原发性高血压（ＥＨＰ）患者和１０名正常对照组的２４ｈ动态血压、尿白蛋白排泄率（ＵＡＥＲ）、转铁蛋白排泄率（ＵＴＥＲ）、视黄醇结合蛋白排泄率（ＵＲ－ＥＲ）及心脏自主神经功能基础上，给ＮＩＤＤＭ和ＥＨＰ组依那普利（１０ｍｇ，ｂｉｄ）共三天，复测２４ｈ动态血压和尿蛋白排泄率。结果三组受试者服药前动态血压皆有昼高夜低的规律，但ＮＩＤＤＭ的动态血压曲线更平坦；且昼夜节律消失（夜间血压下降低于１０％）发生率为６６％，高于ＥＨＰ（５４％）和正常对照组（５０％）；ＮＩＤＤＭ和ＥＨＰ组分别有７５％和６９％的患者出现不同程度的自主神经功能损伤，但动态血压与尿蛋白排泄率间无相关性。经三天依那普利治疗后ＮＩＤＤＭ的２４ｈ平均动脉压（ＭＢＰ）和ＵＡＥＲ由治疗前的１１．７±１．３ｋＰａ和１４．９（２．３～６６）μｇ／ｍｉｎ降为１１．３±１．１ｋＰａ（Ｐ＜０．０１）和８．３（１．１～３８．９）μｇ／ｍｉｎ（Ｐ＜０．０５），２４ｈ平均收缩压（ＳＢＰ）、舒张压（ＤＢＰ）、ＵＴＥＲ和ＵＲ－ＥＲ，白天和夜间的平均ＳＢＰ、ＤＢＰ、ＭＢＰ、ＵＡＥＲ、ＵＴＥＲ和夜间ＵＲＥＲ也明显?
Objective To explore the protective effect of enalapril on the kidneys. Methods The changes of 24h ambulatory blood pressure, urinary albumin excretion (UAER), transferrin excretion (UTER), retinol Based on the urinary excretion rate (UR-ER) and cardiac autonomic nerve function, enalapril (10 mg, bid) was administered to NIDDM and EHP groups for three days. The ambulatory blood pressure and urinary protein excretion rate were measured 24h. Results The ambulatory blood pressure of the three groups of patients had the pattern of daytime and nighttime low, but the dynamic blood pressure curve of NIDDM was more flat. The incidence of diurnal rhythm disappearance (nocturnal blood pressure drop less than 10%) was 66%, which was higher than that of EHP (54%) and normal control group (50%). In 75% and 69% of NIDDM patients and 69% of EHP patients, autonomic nervous dysfunction was found. However, there was no correlation between ambulatory blood pressure and urinary protein excretion rate. After three days of enalapril treatment, the mean arterial blood pressure (MBP) and UAER of NIDDM decreased from 11.7 ± 1.3kPa and 14.9 (2.3 ~ 66) μg / min before treatment to 11.3 (P <0.01), 8.3 (1.1 ~ 38.9) μg / min (P <0.05), 24h mean systolic blood pressure (SBP), diastolic blood pressure (DBP) And UR-ER, mean daytime and nighttime SBP, DBP, MBP, UAER, UTER and night URER also significantly?