摘要
目的探讨依那普利对肾脏保护作用的机制。方法在观察３２名ＮＩＤＤＭ、１３名原发性高血压（ＥＨＰ）患者和１０名正常对照组的２４ｈ动态血压、尿白蛋白排泄率（ＵＡＥＲ）、转铁蛋白排泄率（ＵＴＥＲ）、视黄醇结合蛋白排泄率（ＵＲ－ＥＲ）及心脏自主神经功能基础上，给ＮＩＤＤＭ和ＥＨＰ组依那普利（１０ｍｇ，ｂｉｄ）共三天，复测２４ｈ动态血压和尿蛋白排泄率。结果三组受试者服药前动态血压皆有昼高夜低的规律，但ＮＩＤＤＭ的动态血压曲线更平坦；且昼夜节律消失（夜间血压下降低于１０％）发生率为６６％，高于ＥＨＰ（５４％）和正常对照组（５０％）；ＮＩＤＤＭ和ＥＨＰ组分别有７５％和６９％的患者出现不同程度的自主神经功能损伤，但动态血压与尿蛋白排泄率间无相关性。经三天依那普利治疗后ＮＩＤＤＭ的２４ｈ平均动脉压（ＭＢＰ）和ＵＡＥＲ由治疗前的１１．７±１．３ｋＰａ和１４．９（２．３～６６）μｇ／ｍｉｎ降为１１．３±１．１ｋＰａ（Ｐ＜０．０１）和８．３（１．１～３８．９）μｇ／ｍｉｎ（Ｐ＜０．０５），２４ｈ平均收缩压（ＳＢＰ）、舒张压（ＤＢＰ）、ＵＴＥＲ和ＵＲ－ＥＲ，白天和夜间的平均ＳＢＰ、ＤＢＰ、ＭＢＰ、ＵＡＥＲ、ＵＴＥＲ和夜间ＵＲＥＲ也明显?
bjective To investigate the protective mechanism of Enalapril on kidney. Methods Changes of 24 hour ambulatory blood pressure, urine protein excretion rates and autonomic nerve function were observed in 32 normotensive NIDDM pateints, 13 essential hypertensive pateints and 10 normal control subjects, and differences of ambulatory blood pressure and urine protein excretion rates before and after 3 days of treatment of Enalapril (10mg,bid) were then compared in both NIDDM and EHP group. Results The high peak and low peak of 24 hour ambulatory blood pressure appeared in the morning and at night in all three groups, but the blood pressure curve was planter in NIDDM and the percentage of disappeared diurnal rhythm of ambulatory blood pressure (blood pressure at nignttime falls less than 10%) was 66%, higher than in EHP (54%) and normal control (50%), the damagement of autonomic nerves appeared in 75% of NIDDM and 69% of EHP, but no relationship was observed between ambulatory blood pressure and urinary protein excretion rates. After treatment for 3days, MBP, DBP, SBP, UAER, UTER of 24 hour and daytime and URER of nighttime decreased significantly in NIDDM group; 24 hour ambulatory blood pressure remained unchanged except SBP of nighttime, and UAER of 24 hour, daytime and nighttime decreased significantly in EHP group. Conclusion Enalapril may have a specific protect effect on kidney function independent of its effect on systemic blood pressure.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
1998年第1期19-23,共5页
Chinese Journal of Nephrology
基金
国家自然科学基金
上海市卫生局基金
关键词
糖尿病
NIDDM
高血压
EHP
药物疗法
依那普利
Non insulin dependent diabetes mellitus Essential hypertension Enalapril Ambulatory blood pressure Urine protein excreation rates
