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大约有40%的胰岛素依赖型糖尿病(IDDM)发展为糖尿病性肾病,包括持续蛋白尿,肾小球滤过率(GFR)下降及高血压等一组临床综合征,肾功能衰竭是此型糖尿病的主要死亡原因,高血压加剧糖尿病肾小球病变。作者研究了长期积极降压治疗对糖尿病肾病的 GFR 及蛋白尿的影响。研究对象为14例 IDDM 患者(2例以后因故退出)。先经过至少23个月非治疗对比期。如反复测血压舒张压≥100mmHg,或舒张压持续≥90mmHg,过去2年内平均动脉压增长了10mmHg,则开始降压治疗。大部分病人采用美多心安、肼苯哒嗪、速尿或噻嗪类利尿剂等三药联合降压,2例病人因出现低血糖停用美多心安,分别改换甲基多巴及哌唑嗪,使平均动脉压至少持续下降10mmHg。全部检查项目均在上午9时到下午1时之间进行。检查前照常进早餐和注射晨
Approximately 40% of insulin-dependent diabetes mellitus (IDDM) develop into diabetic nephropathy, including a group of clinical syndromes of persistent proteinuria, glomerular filtration rate (GFR) decline and hypertension, which is the type of diabetes mellitus The main cause of death, hypertension exacerbates diabetic glomerular lesions. The authors studied the effects of long-term aggressive antihypertensive therapy on GFR and proteinuria in diabetic nephropathy. The subjects were 14 IDDM patients (2 patients later for some reason). After at least 23 months non-treatment contrast. Such as repeated measured diastolic blood pressure ≥ 100mmHg, or diastolic blood pressure continued ≥ 90mmHg, the past two years the average arterial pressure increased by 10mmHg, then start antihypertensive treatment. The majority of patients with the United States and more peace of mind, hydralazine, furosemide or thiazide diuretics and other three drugs combined with antihypertensive, 2 patients due to the emergence of hypoglycemic Metoprolol, were replaced by methyldopa and prazole Triazine, the average arterial pressure continued to decline at least 10mmHg. All inspection items are conducted between 9:00 am and 1:00 pm As usual, check breakfast and morning injection