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选择2型糖尿病早期肾小球高滤过患者60例,以双盲随机方式,1/4患者服ARB,1/4患者服ACEI,1/4患者服ARB+ACEI,1/4患者服安慰剂,缬沙坦40~80mg/d,依拉普利10~20mg/d,每3个月测定一次血糖、HbA1c、血压、Scr、每6个月测定肾体积、GFR、URAE,共用药12月。结果:各组血压下降(P<0.01),ACEI组与ARB组相比无差异,ACEI+ARB组较ACEI组及ARB组血压下降(P<0.01)。治疗前后ACEI组及ARB组KV、GFR无明显变化,UAER有下降趋势,但无差异。ACEI+ARB组治疗前后KV、GFR、UAER均出现有意义的下降(P<0.05)。安慰组变化不明显。结论:ACEI及ARB联台能改善糖尿病患者早期肾小球高滤过状态,阻止和延缓糖尿病肾病的发生与发展。
Sixty patients with type 2 diabetic patients with early glomerular hyperfiltration were selected and treated with ARB + ACEI in 1/4, ARA in 1/4, ACEI in 1/4, ARB + ACEI in 1/4 in a double-blind randomized manner , Valsartan 40 ~ 80mg / d, enalapril 10 ~ 20mg / d, blood glucose, HbA1c, blood pressure and Scr were measured every 3 months, and the renal volume, GFR and URAE were measured every 6 months month. Results: The blood pressure decreased in each group (P <0.01). There was no difference between ACEI group and ARB group. The blood pressure decreased in ACEI + ARB group compared with ACEI group and ARB group (P <0.01). There was no significant change of KV and GFR between ACEI group and ARB group before and after treatment, UAER had a downward trend, but no difference. There was a significant decrease of KV, GFR and UAER before and after treatment in ACEI + ARB group (P <0.05). Comfortable group did not change significantly. Conclusion: ACEI and ARB combined with Taiwan can improve diabetic glomerular hyperfiltration early state, prevent and delay the occurrence and development of diabetic nephropathy.