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目的 :探讨血管紧张素Ⅱ (AngⅡ )受体阻断剂氯沙坦对糖尿病肾病 (DN)的治疗和保护作用与机制。方法 :5 2例患者随机分为氯沙坦 5 0mg组 (n =2 7)和 10 0mg组 (n =2 5 ) ,分别服氯沙坦 5 0和 10 0mg·d-1,po,qd ,疗程 8周。观察服药前后血压、血钾、血尿酸、2 4h尿白蛋白排泄率 (UAE)及血清中AngⅡ、一氧化氮 (NO)、内皮素(ET)、转化生长因子 β1(TGF β1)的变化。结果 :服用氯沙坦后 ,患者的血压、血尿酸和UAE ,ET ,TGF β1均下降 ,血钾无明显升高 ,AngⅡ和NO升高。 10 0mg组比 5 0mg组作用明显。 结论 :氯沙坦不仅通过对AngⅡ的作用 ,而且还可通过对NO ,ET ,TGF β1的影响来达到对DN的治疗和保护作用。
Objective: To investigate the therapeutic and protective effects of losartan on diabetic nephropathy (DN) by angiotensin Ⅱ (AngⅡ) receptor antagonist. Methods: Fifty-two patients were randomly divided into losartan 50 mg group (n = 27) and 10 mg group (n = 25), losartan 50 and 10 0 mg · d-1, po, qd , Treatment for 8 weeks. Blood pressure, serum potassium, serum uric acid, 24 h urinary albumin excretion rate (UAE), serum Ang Ⅱ, nitric oxide (NO), endothelin (ET) and transforming growth factor β1 (TGFβ1) were observed before and after treatment. Results: After taking losartan, the blood pressure, serum uric acid, UAE, ET, TGFβ1 decreased, but the serum potassium did not increase obviously. The levels of AngⅡ and NO increased. 10 0 mg group than the role of 50 mg group obvious. CONCLUSION: Losartan can not only treat and protect DN through its effect on AngⅡ, but also through its effects on NO, ET and TGFβ1.