Barkai L, Soós A, Vámosi I
Haynal Imre Egészségtudományi Egyetem Orvostovábbképzó Kar, II. Gyermekgyógyászati Tanszék, Miskolc.
Orv Hetil. 1996 Nov 17;137(46):2565-8.
In the present study the effect of angiotensin converting enzyme inhibitor captopril was studied in normotensive diabetic children and adolescents with persistent microalbuminuria (repeated albumin excretion rate higher than 30 mg/24 h). In 1993/1994, 15 microalbuminuric patients (age: 10-17 yrs, diabetes duration: 6.5 +/- 3.0 yrs) had been treated with captopril (0.9 mg/kg/day for a period of 13.1 +/- 4.4 months). In 1992/1993, 13 patients (age: 11-17 yrs, diabetes duration: 5.8 +/- 2.7 yrs, study period: 12.3 +/- 4.0 months) had not received captopril. Same restriction of the dietary protein intake was recommended in both groups (less than 10% of the total calorie intake). Timed 24-h urine samples were used to determine albumin excretion by an immunonephelometric method. Significant increase in microalbuminuria was observed in patients who had not received captopril during the study period (56.2 +/- 16.0 mg/24 h vs. 77.8 +/- 20.1 mg/24 h, p = 0.045). There was no change in microalbuminuria in the captopril treated group during the study period (60.6 +/- 19.5 mg/24 h vs. 60.4 +/- 25 mg/24 h, n. s.). No change in metabolic control and blood pressure was observed in the two groups during the study period. These results support that captopril treatment may prevent or delay the progression of incipient nephropathy in normotensive children and adolescents in diabetes.
在本研究中，对血压正常、患有持续性微量白蛋白尿（重复白蛋白排泄率高于30mg/24小时）的糖尿病儿童和青少年，研究了血管紧张素转换酶抑制剂卡托普利的作用。1993年/1994年，15例微量白蛋白尿患者（年龄：10 - 17岁，糖尿病病程：6.5±3.0年）接受了卡托普利治疗（0.9mg/kg/天，为期13.1±4.4个月）。1992年/1993年，13例患者（年龄：11 - 17岁，糖尿病病程：5.8±2.7年，研究期：12.3±4.0个月）未接受卡托普利治疗。两组均建议限制饮食中蛋白质摄入量（低于总热量摄入的10%）。采用定时24小时尿样，通过免疫比浊法测定白蛋白排泄量。研究期间未接受卡托普利治疗的患者，微量白蛋白尿显著增加（56.2±16.0mg/24小时对77.8±20.1mg/24小时，p = 0.045）。卡托普利治疗组在研究期间微量白蛋白尿无变化（60.6±19.5mg/24小时对60.4±25mg/24小时，无统计学意义）。研究期间两组的代谢控制和血压均无变化。这些结果支持卡托普利治疗可能预防或延缓糖尿病血压正常的儿童和青少年早期肾病的进展。
