目的：探讨螺内酯联合福辛普利治疗2型糖尿病肾病的安全性及其对蛋白尿的影响。方法60位2型糖尿病肾病患者随机平均分为对照组和治疗组，对照组予福辛普利10 mg／d治疗，治疗组在对照组用药基础上加用螺内酯20 mg／d治疗，试验持续12周，定期测量患者血压、生化指标及24 h尿蛋白定量。结果与对照组比较，治疗组24 h尿蛋白下降更显著（P＜0．01），无肾小球滤过率下降、血钾上升及低血压发生。结论适度剂量的螺内酯能加强血管紧张素转化酶抑制剂（ACEIs）对糖尿病肾病的阻滞作用。%Objective To investigate the safety and the effect of proteinuria of spironolactone and fosinopril on type 2 diabetic nephropathy. Methods sixty type 2 diabetic patients with nephropathy were randomly devided into control group and case group,the control group received fosinopril (10 mg/d) and case group took additive therapy with spironolactone (20 mg/d) for 12 weeks, blood pressure,biochemical parameters and 24-h proteinuria were determined for each patient at regular intervals. Results 24-h proteinuria reduced more significantly in case group compared to control group (P<0.01),the patients did not develop any significant adverse effect including distinct reduction in GFR, hyperkalemia and hypotension. Conclusion Low to moderate doses of spironolactone can augment the effect of ACEIs in the prevention of diabetes nephropathy.
展开▼
