替米沙坦降低血管紧张素酶抑制剂治疗 2 型糖尿病患者的蛋白尿。
Telmisartan lowers albuminuria in type 2 diabetic patients treated with angiotensin enzyme inhibitors.
机构信息
Department of Nephrology, Transplantology and Dialysis Unit, Medical University of Białystok, Białystok, Poland.
出版信息
Adv Med Sci. 2009;54(1):37-40. doi: 10.2478/v10039-009-0015-6.
PURPOSE
Angiotensin-converting-enzyme inhibitors (ACEIs) provide renal protection in patients with type 2 diabetes and microalbuminuria.
MATERIAL AND METHODS
In the presented study we followed 34 stable, type 2 diabetic patients with persistent albuminuria treated with maximal doses of ACEIs as a part of their anti-hypertensive treatment. Telmisartan--an angiotensin receptor blocker (ARB)--in a dose of 40 mg was added to the treatment and the patients were observed for 12 weeks. We measured creatinine clearance, 24-hour urinary albumin excretion, before and after 12 weeks of combined therapy.
RESULTS
The addition of telmisartan resulted in a significant reduction of albuminuria from median 157 to 67 mg/24h. No change in creatinine clearance was observed (93 vs 97 ml/min).
CONCLUSION
The addition of telmisartan to a maximum dose of ACEI is safe and results in further albuminuria decrease in patients with type 2 diabetes and incipient nephropathy.
目的
血管紧张素转换酶抑制剂（ACEI）可提供对 2 型糖尿病和微量白蛋白尿患者的肾脏保护作用。
材料和方法
在本研究中，我们随访了 34 名稳定的 2 型糖尿病患者，这些患者持续存在白蛋白尿，正在接受最大剂量 ACEI 治疗，作为其降压治疗的一部分。将血管紧张素受体阻滞剂（ARB）替米沙坦（剂量为 40 mg）添加到治疗中，并观察患者 12 周。我们在联合治疗前和治疗后 12 周测量了肌酐清除率和 24 小时尿白蛋白排泄量。
结果
替米沙坦的添加使白蛋白尿从中位数 157 降至 67mg/24h，显著减少。肌酐清除率无变化（93 与 97ml/min）。
结论
在最大剂量 ACEI 的基础上加用替米沙坦是安全的，并可使 2 型糖尿病和早期肾病患者的白蛋白尿进一步减少。
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