Rell K, Linde J, Morzycka-Michalik M, Gaciong Z, Lao M
Transplantation Institute, Warsaw Medical Academy, Poland.
Transpl Int. 1993;6(4):213-7. doi: 10.1007/BF00337102.
We studied the effect of enalapril, an inhibitor of angiotensin-converting enzyme (iACE), on proteinuria and renal function in recipients of renal allografts. Twenty-two patients with post-transplant nephrotic syndrome were treated with incremental doses of enalapril for 1 year. Urinary protein excretion decreased after 2 months of treatment from a mean of 8.9 g/day (range 4.0-18.9 g/day) to 4.5 g/day (range 0.4-10.0 g/day; P < 0.01) and remained significantly low for the rest of the study. However, in the same period, creatinine clearance did not change significantly; it went from 47.8 ml/min (range 17.1-110.3 ml/min) before treatment to 44.2 ml/min (range 16.5-88.5 ml/min) after 2 months of iACE therapy. Analysis of individual data showed that there was a significant reduction in proteinuria in 14 of the 22 patients and that the rate of deterioration of renal function did not increase in 17 of the 22 patients. We did not observe any serious side effects of enalapril administration. The results of our study prove that iACE can be used safely and effectively to reduce post-transplant proteinuria.
我们研究了血管紧张素转换酶抑制剂（iACE）依那普利对肾移植受者蛋白尿和肾功能的影响。22例移植后肾病综合征患者接受了递增剂量的依那普利治疗，为期1年。治疗2个月后，尿蛋白排泄量从平均每天8.9克（范围4.0 - 18.9克/天）降至4.5克/天（范围0.4 - 10.0克/天；P < 0.01），且在研究的剩余时间内一直显著低于治疗前。然而，在同一时期，肌酐清除率没有显著变化；治疗前为47.8毫升/分钟（范围17.1 - 110.3毫升/分钟），iACE治疗2个月后降至44.2毫升/分钟（范围16.5 - 88.5毫升/分钟）。个体数据分析显示，22例患者中有14例蛋白尿显著减少，22例患者中有17例肾功能恶化率未增加。我们未观察到依那普利给药有任何严重副作用。我们的研究结果证明，iACE可安全有效地用于降低移植后蛋白尿。
