Jungmann E, Schumm-Draeger P M, Scheuermann E H, Usadel K H
Abteilung für Endokrinologie, Universitätsklinikums Frankfurt/M.
Fortschr Med. 1992 Apr 30;110(12):224-6.
Detection of possible effects on renal function parameters of long-term antihypertensive treatment administered to patients with diabetes mellitus.
Prolongation of an open trial, initially planned for one year, on the effect of felodipine 10 mg/day in diabetics (Fortschr. Med. 109 (1991), 53-56). Continued treatment of 7 hypertensive insulin-dependent diabetics (mean age 58 +/- 3 years, HbA1 8.2 +/- 0.3%) over a period of between 24 and 32 months.
The lowered blood pressure (from 160/94 to 150/82 mmHg; p less than 0.05) persisted. In the first 6 months of treatment, urinary albumin excretion (UAE) remained constant. Thereafter it increased (p less than 0.05 as compared with the figure seen after 6 months' treatment) to a degree that varied from one patient to another; overall, the UAE figures showed a relatively large intra-individual fluctuation during long-term therapy. Metabolic parameters remained uninfluenced by felodipine.
It cannot be excluded that progression of diabetic renal disease cannot be adequately prevented by long-term treatment with calcium antagonists such as felodipine.
检测长期抗高血压治疗对糖尿病患者肾功能参数的可能影响。
将一项最初计划为期一年的开放试验延长,该试验旨在研究每日服用10毫克非洛地平对糖尿病患者的影响(《医学进展》109 (1991),53 - 56)。对7名高血压胰岛素依赖型糖尿病患者(平均年龄58 ± 3岁,糖化血红蛋白8.2 ± 0.3%)进行为期24至32个月的持续治疗。
血压降低(从160/94毫米汞柱降至150/82毫米汞柱;p < 0.05)的情况持续存在。在治疗的前6个月,尿白蛋白排泄量(UAE)保持稳定。此后其有所增加(与治疗6个月后的数值相比,p < 0.05),增加程度因人而异;总体而言,在长期治疗期间,UAE数值显示出相对较大的个体内波动。代谢参数未受非洛地平影响。
不能排除像非洛地平这样的钙拮抗剂长期治疗无法充分预防糖尿病肾病进展的可能性。