Josefsberg Z, Ross S A, Lev-Ran A, Hwang D L
Faculty of Medicine, University of Calgary, Alberta, Canada.
Diabetes Care. 1995 May;18(5):690-3. doi: 10.2337/diacare.18.5.690.
To compare the effect of the antihypertensive drugs nitrendipine and enalapril on the excretion of epidermal growth factor (EGF) and albumin in hypertensive non-insulin-dependent diabetes mellitus (NIDDM) subjects.
After a 4-week washout period, mildly hypertensive (systolic blood pressure [sBP] > or = 140 mmHg and/or diastolic blood pressure [dBP] > or = 90 mmHg) NIDDM patients with albuminuria (15-200 micrograms/min) were randomized into an 8-month-long therapy with either nitrendipine (n = 11) or enalapril (n = 10). Blood pressure, EGF, and microalbumin excretion were measured at baseline and throughout the treatment period.
A significant fall in sBP was noticed in the enalapril group and in dBP in the nitrendipine group. In the enalapril group, EGF excretion progressively increased from 188 to 214 nmol/mmol creatinine after 6 weeks and to 274 after 8 months of therapy (P = 0.03). There was a significant fall in albumin excretion while patients were on enalapril, but in the nitrendipine group, neither albuminuria nor EGF excretion changed significantly. There was no correlation of improved EGF excretion with a decrease in albuminuria or BP.
The angiotensin-converting enzyme inhibitor enalapril has been effective in decreasing albumin and increasing EGF excretion. Measurement of urinary EGF may provide a new valuable index of renal function.
比较降压药物尼群地平和依那普利对高血压非胰岛素依赖型糖尿病（NIDDM）患者表皮生长因子（EGF）和白蛋白排泄的影响。
经过4周的洗脱期后，将轻度高血压（收缩压[sBP]≥140 mmHg和/或舒张压[dBP]≥90 mmHg）且有蛋白尿（15 - 200微克/分钟）的NIDDM患者随机分为两组，分别接受为期8个月的尼群地平治疗（n = 11）或依那普利治疗（n = 10）。在基线期及整个治疗期间测量血压、EGF和微量白蛋白排泄量。
依那普利组sBP显著下降，尼群地平组dBP显著下降。在依那普利组，治疗6周后EGF排泄量从188纳摩尔/毫摩尔肌酐逐渐增加至214，治疗8个月后增至274（P = 0.03）。患者服用依那普利时白蛋白排泄量显著下降，但在尼群地平组，蛋白尿和EGF排泄量均无显著变化。EGF排泄量的改善与白蛋白尿或血压的降低无相关性。
血管紧张素转换酶抑制剂依那普利在降低白蛋白和增加EGF排泄方面有效。测定尿EGF可能为肾功能提供一个新的有价值指标。
