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近年来临床上不断证实卡托普利对糖尿病性肾病具有一定的治疗作用。美国FDA现在已正式批准此药可用于治疗胰岛素依赖型糖尿病病人并发的糖尿病性肾病。卡托普利的这一新适应证可以让糖尿病患者延后或避免进入末期肾病的致命境地。 1 作用机制 动物实验研究显示,由于血管紧张素转换酶受到抑制,阻断血管紧张素Ⅱ形成,从而抑制血管收缩,降低入球动脉的阻力和小球毛细管压力。这种作用独立于药物时全身血压的影响;与ACE抑制剂的抗高血压药物不一样,不可能降低小球毛细管压。在临床研究中,ACE抑制剂治疗糖尿病病人与其它抗高血压药物相比,虽然降低血压作用相似,但却较少出现蛋白尿。
In recent years, celecoxib has been clinically proven to have a therapeutic effect on diabetic nephropathy. The FDA has now officially approved the drug for the treatment of diabetic nephropathy associated with insulin-dependent diabetes mellitus. This new indication of captopril can delay or prevent the onset of end-stage renal disease in diabetic patients. 1 Mechanism Experimental studies in animals show that as angiotensin converting enzyme is inhibited, the formation of angiotensin II is blocked, thereby inhibiting the vasoconstriction, reducing the resistance of the arterial bulb and the capillary pressure of the capillaries. This effect is independent of the systemic blood pressure of the drug; unlike ACE inhibitors, antihypertensives, it is not possible to reduce the capillary pressure of the globules. In clinical studies, ACE inhibitors treatment of diabetic patients compared with other antihypertensive drugs, although similar to lower blood pressure, but less proteinuria.