Passa P, Marre M, Leblanc H
Service de Diabétologie-Endocrinologie, Hôpital St-Louie, Paris.
Presse Med. 1987 Dec 19;16(44):2221-5.
In insulin-dependent diabetics the course of the renal disease can be followed by measuring arterial blood pressure and urinary albumin excretion. Already at the stage of incipient nephropathy (microalbuminuria) a moderate but gradually increasing rise in blood pressure is noticeable. At the stage of patent nephropathy (macroalbuminuria) nothing but an effective antihypertensive treatment can slow down the deterioration of renal function and delay by a few years the occurrence of end-stage renal failure. When macroproteinuria or obvious arterial hypertension are present, it is much too late to institute an antihypertensive treatment. To really prevent diabetic nephropathy, this treatment must be given earlier, as soon as microalbuminuria is detected and irrespective of blood pressure values. Prescribing antihypertensive drugs, and especially angiotensin-converting enzyme inhibitors, seems to be the most effective way of reducing urinary albumin excretion. 6
在胰岛素依赖型糖尿病患者中，可通过测量动脉血压和尿白蛋白排泄量来追踪肾脏疾病的病程。在肾病初期（微量白蛋白尿）阶段，血压就会出现适度但逐渐上升的情况。在显性肾病（大量白蛋白尿）阶段，只有有效的抗高血压治疗才能减缓肾功能恶化，并将终末期肾衰竭的发生推迟数年。当出现大量蛋白尿或明显的动脉高血压时，开始抗高血压治疗就为时已晚。要真正预防糖尿病肾病，这种治疗必须尽早进行，一旦检测到微量白蛋白尿就要开始，而不必考虑血压值。开抗高血压药物，尤其是血管紧张素转换酶抑制剂，似乎是减少尿白蛋白排泄的最有效方法。 6
