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目的 探讨ACEI肾保护作用的有效剂量。方法 原发性肾小球疾病患者 15 4例。分别实施Captopril、Cilazapril和Enalapril各高、低两个剂量组以及作为对照给予Amlodipine治疗 4个月。治疗前、后每月检测平均动脉压、尿蛋白、尿白蛋白排泄率、尿钠、尿尿素氮和肾功能 ,并检测患者ACE基因表型。结果 ①各组间ACE基因表型分布和蛋白质、食盐摄入量无明显差别 ;②三种ACEI的高、低剂量组间的抗尿蛋白作用和对肾功能的影响无明显差别。结论 对原发性肾小球疾病患者低剂量的ACEI也具备良好的肾保护作用。
Objective To investigate the effective dose of ACEI for renal protection. Methods Fifty-four patients with primary glomerular disease. Each of the high and low dose groups of Captopril, Cilazapril and Enalapril was administered separately and Amlodipine was administered as a control for 4 months. Mean arterial pressure, urinary protein, urinary albumin excretion rate, urinary sodium, urinary urea nitrogen and renal function were measured before and after treatment. ACE gene phenotype was detected in all patients. Results ① There was no significant difference in ACE gene phenotype distribution and protein and salt intake between the two groups. ② There was no significant difference in anti-urinary protein and renal function among the three ACEI groups. Conclusions A low dose of ACEI in patients with primary glomerular disease also has good renal protection.