Sumida Y, Yano Y, Murata K, Goto H, Ura H, Ezaki J, Tsutsumi S, Shirayama K, Misaki M, Shima T
Third Department of Internal Medicine, Mie University School of Medicine, Japan.
J Int Med Res. 1997 May-Jun;25(3):117-26. doi: 10.1177/030006059702500301.
A 24-week study was conducted to evaluate the effects of the dihydropyridine calcium channel blocker nilvadipine on urinary albumin excretion in eight microalbuminuric hypertensive patients with non-insulin-dependent (type II) diabetes mellitus. Blood pressure and urinary albumin excretion measurements before the administration of nilvadipine (8 mg) were compared with those after 4, 8, 12 and 24 weeks of treatment. No significant changes were observed in the mean values of haemoglobin A1C. Systolic blood pressure was significantly reduced from 174 +/- 23 mmHg before treatment to 144 +/- 13 mmHg after 24 weeks of treatment (P < 0.02). Diastolic blood pressure was significantly reduced from 93 +/- 11 mmHg at baseline to 79 +/- 8 mmHg after 24 weeks of treatment (P < 0.05). Urinary albumin excretion was significantly reduced from 65.4 +/- 37.4 mg/g creatinine at baseline to 51.6 +/- 41.1 mg/g creatinine (P < 0.05) after 4 weeks, and to 39.1 +/- 26.9 mg/g creatinine (P < 0.02) after 24 weeks of treatment. These data suggest that in hypertensive microalbuminuric patients with non-insulin-dependent diabetes mellitus, treatment of hypertension with the calcium blocker nilvadipine may slow the progression of diabetic nephropathy.
进行了一项为期24周的研究，以评估二氢吡啶类钙通道阻滞剂尼伐地平对8例非胰岛素依赖型（II型）糖尿病微量白蛋白尿高血压患者尿白蛋白排泄的影响。将服用尼伐地平（8毫克）前的血压和尿白蛋白排泄测量值与治疗4、8、12和24周后的测量值进行比较。血红蛋白A1C的平均值未观察到显著变化。收缩压从治疗前的174±23毫米汞柱显著降低至治疗24周后的144±13毫米汞柱（P<0.02）。舒张压从基线时的93±11毫米汞柱显著降低至治疗24周后的79±8毫米汞柱（P<0.05）。尿白蛋白排泄在治疗4周后从基线时的65.4±37.4毫克/克肌酐显著降低至51.6±41.1毫克/克肌酐（P<0.05），治疗24周后降至39.1±26.9毫克/克肌酐（P<0.02）。这些数据表明，在非胰岛素依赖型糖尿病高血压微量白蛋白尿患者中，用钙阻滞剂尼伐地平治疗高血压可能会减缓糖尿病肾病的进展。
