EFFECT OF ANTIHYPERTENSIVE TREATMENT ON KIDNEY-FUNCTION IN DIABETIC NEPHROPATHY
EFFECT OF ANTIHYPERTENSIVE TREATMENT ON KIDNEY-FUNCTION IN DIABETIC NEPHROPATHY
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DOI：
10.1136/bmj.294.6585.1443
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发表时间：
1987-06-06
影响因子：
105.7
通讯作者：
SVENDSEN, PA
中科院分区：
文献类型：
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作者：
PARVING, HH;ANDERSEN, AR;SVENDSEN, PA
前瞻性研究了11例胰岛素依赖型糖尿病患者(平均年龄30岁)长期积极降压治疗对糖尿病肾病患者肾功能的影响。治疗前平均32个月(23~66个月)，肾小球滤过率显着降低，蛋白尿和动脉血压显着升高。在72个月(32-91个月)的降压治疗期间，平均动脉压从143/96毫米汞降至129/84毫米汞，蛋白尿从1038微克/分钟降至504微克/分钟。肾小球滤过率下降率由治疗前的0.89(0.44~1.46)ml/min/月降至治疗后的0.22(0.01~0.40)ml/min/月。在接受长期抗高血压治疗的患者中，与前三年相比，后三年肾小球滤过率的下降速度明显较小(。6年)。1例死于急性心肌梗死(肾小球滤过率46ml/min/1.74m2)。有效的降压治疗可延缓糖尿病肾病患者的肾功能不全。
The effect of long term, aggressive antihypertensive treatment on kidney function in diabetic nephropathy was studied prospectively in 11 insulin dependent diabetics (mean age 30). During the mean pretreatment period of 32 (range 23-66) months the glomerular filtration rate decreased significantly and albuminuria and the arterial blood pressure increased significantly. During the 72 (range 32-91) month period of antihypertensive treatment the average arterial blood pressure fell from 143/96 mm Hg to 129/84 mm Hg and albuminuria decreased from 1038 .mu.g/min to 504 .mu.g/min. The rate of decline in the glomerular filtration rate decreased from 0.89 (range 0.44-1.46) ml/min/month before treatment to 0.22 (range 0.01-0.40) ml/min/month during treatment. The rate of decline in the glomerular filtration rate was significantly smaller during the second three years compared with the first three years in patients who received long term antihypertensive treatment (.gtoreq. 6 years). One patient died from acute myocardial infarction (glomerular filtration rate 46 ml/min/1.74 m2). Effective antihypertensive treatment postpones renal insufficiency in diabetic nephropathy.