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血管紧张素转化酶抑制剂(ACEI)及受体拮抗剂(ARB)是临床上常用的治疗糖尿病肾病的药物,长期应用可降低糖尿病患者肾小球损伤、减少蛋白尿[1]。然而越来越多的临床证据发现“醛固酮逃逸现象”的发生导致ACEI或ARB靶器官保护效应逐渐消失。联合应用醛固酮受体拮抗剂和ARB较ARB单药治疗在降低尿微量清蛋白排泄率(UAER)方面治疗的效果更好,具有更好的肾保护作用[2]。本例糖尿病肾病患者因联
Angiotensin converting enzyme inhibitors (ACEIs) and receptor antagonists (ARBs) are clinically common drugs for the treatment of diabetic nephropathy. Long-term use can reduce glomerular injury and reduce proteinuria in diabetic patients [1]. However, more and more clinical evidences show that the occurrence of “aldosterone escape phenomenon” causes the target organ protective effect of ACEI or ARB to gradually disappear. Combination of aldosterone receptor antagonist and ARB than ARB monotherapy in the treatment of lower urinary albumin excretion rate (UAER) treatment is better, with better renal protection [2]. This case of patients with diabetic nephropathy due to association