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目的:对Ⅱ型糖尿病患者进行长期尿微量白蛋白监测,观察血管紧张素转换酶抑制剂(ACEI)预防糖尿病肾病(DN)的作用。方法:对象为尿微白蛋白<30mg/24Ⅱ型糖尿病患者。血压正常治疗组27人,给予卡托普利,高血压治疗组15人,在其它抗高血压治疗的基础上加用卡托普利,同时设没有使用卡托普利的对照组病人。每3个月检查一次尿微白蛋白。结果:长达33个月～54个月的观察,血压正常者治疗组有6例(6/27)转为微白蛋白尿,无1例发展为临床白蛋白尿,对照组4例(4/27)转为微白蛋白尿,1例(1/27)转为临床白蛋白尿,P=0.49;高血压治疗组有1例(1/15)转为微蛋白尿,对照组3例(3/15)转为微白蛋白尿,P=0.28。上述治疗组与对照组结果比较均无显著性差异(P>0.05)。结论:ACEI不能阻止糖尿病患者微白蛋白尿形成和不能预防DN的发生。
OBJECTIVE: To monitor long-term urine microalbuminuria in type 2 diabetic patients and observe the role of angiotensin converting enzyme inhibitor (ACEI) in preventing diabetic nephropathy (DN). Methods: The subjects were urine microalbumin <30mg / 24 type II diabetics. Twenty-seven patients in the normotensive group received captopril and 15 in the hypertensive group. Captopril was administered on the basis of other antihypertensives and no control group was given captopril. Urine microalbumin is checked every 3 months. Results: In the observation period from 33 months to 54 months, 6 cases (6/27) in the normotensive patients turned to microalbuminuria, none developed clinical albuminuria, and 4 cases in the control group (4 / 27) to microalbuminuria, 1 case (1/27) to clinical albuminuria, P = 0.49; 1 case (1/15) in hypertension group was converted to microalbuminuria and 3 cases in control group (3/15) to microalbuminuria, P = 0.28. There was no significant difference between the above treatment group and control group (P> 0.05). Conclusion: ACEI can not prevent the formation of microalbuminuria in diabetic patients and can not prevent the occurrence of DN.