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作者报道了严重慢性肾病患者经血管紧张素转化酶抑制剂Enalapril治疗后,肾脏DMSA(二巯基琥珀酸)摄取量和GFR(肾小球滤过率)的改变.方法:慢性进展性肾病共31例(男16,女15,29～71岁),包括肾小球肾炎7例,肾小管间质肾病、糖尿病肾病、多囊性肾病和原因不明的肾病各6例.研究开始前至少3个月,GFR<30ml/(min·1.73m~2)的非糖尿病患者限制蛋白摄入量:GFR<16ml/(min·1.73m~2)的13例蛋白量限制为0.5g/(kg·天);GFR在16～29ml/(min·1.73m~2)的9例限制为lg/(kg·天).糖尿病者则不限制蛋白摄入量.所有患者无低血钠症,无上尿路扩张.Enalapril给药:住院后第一天上午9点试用量2.5mg,卧床监测血压5h,下午8点再服2.5～5mg.次日上午8点口服2.5～5mg.入院前2周和治疗第2天做下列检查:①4MBq~(51)Cr-EDTA静注后,根据不同时间的血浆清除率计算GFR;②80MBq~(99m)Tc-DMSA静
The authors report the changes in renal DMSA (dithioglycolic acid uptake) and GFR (glomerular filtration rate) in patients with severe chronic kidney disease treated with the Enalapril inhibitor of angiotensin-converting enzyme.Methods: A total of 31 patients with chronic progressive nephropathy Cases (male 16, female 15,29 to 71 years), including glomerulonephritis in 7 cases, tubulointerstitial nephropathy, diabetic nephropathy, polycystic kidney disease and unexplained nephropathy in 6 cases.Study before the start of at least 3 Month, GFR <30ml / (min · 1.73m ~ 2) of non-diabetic patients with restricted protein intake: GFR <16ml / (min · 1.73m ~ 2) of the 13 cases of protein content was limited to 0.5g / (kg · day ), GFR was limited to 1g / (kg · day) in 9 cases of 16 ~ 29ml / (min · 1.73m ~ 2) .The diabetic patients did not limit the protein intake.All patients had no hyponatremia and no upper urinary Road dilatation.Enalapril administration: the first day after hospitalization at 9 am trial dose of 2.5mg, bed rest monitoring blood pressure 5h, 8 pm and then served 2.5 ~ 5mg. 8 o’clock the next day oral 2.5 ~ 5mg. 2 weeks before admission and treatment The following 2 days to do the following checks: ① 4MBq ~ (51) Cr-EDTA after intravenous injection, according to different time of plasma clearance calculated GFR; ② 80MBq ~ (99m) Tc-DMSA static