论文部分内容阅读
目的 评价苯那普利对肺结核并糖尿病患者应用链霉素的肾毒性防护效果,并以卡托普利为临床对 照。方法 114例初治肺结核并糖尿病患者随机分为3组,治疗A组45例,治疗B组39例,对照组30例。3组病 例均采用含2或3个月链霉素疗程的标准方案进行抗结核,用口服降糖药或/和胰岛素治疗糖尿病。治疗A组和 治疗B组在用链霉素治疗期间分别加用苯那普利与卡托普利,在治疗开始与结束时分别检测尿微量白蛋白、β2— 微球蛋白,血肌酐、糖化血红蛋白、血糖、血尿素氮、血肌酐清除率及血压。结果 治疗A组与治疗B组尿微量白蛋 白、β2—微球蛋白治疗后较治疗前均无明显升高(P>0.05),治疗期间两组分别出现1例微量蛋白尿,而对照组出 现6例微量蛋白尿,1例临床蛋白尿。治疗A组与治疗B组治疗前后血肌肝、血尿素氮、血肌肝清除率无明显变化 (P>0.05),而对照组治疗后明显升高(P<0.01)。对照组治疗后较治疗前尿微量白蛋白和β2-微球蛋白明显增 加(P<0.01)。三组血糖、糖化血红蛋白、血压治疗前后无明显差异(P>0.05)。结论 苯那普利可明显降低尿 微量白蛋白和β2—微球蛋白,保护肾功能,对链霉素的肾毒性有较明显的防护作用,值得临床推广。
Objective To evaluate the protective effect of benazepril on nephrotoxicity of streptomycin in patients with pulmonary tuberculosis and diabetes mellitus, and to use captopril as a clinical control. Methods One hundred and fourteen patients with newly diagnosed pulmonary tuberculosis and diabetes were randomly divided into three groups: treatment A group 45 cases, treatment B group 39 cases and control group 30 cases. Three groups of patients were treated with standard regimens of 2 or 3 months of streptomycin for antituberculous treatment of diabetes with oral hypoglycemic agents or / and insulin. Treatment A and B were treated with benazepril and captopril respectively during streptomycin treatment, and urine microalbumin, β2-microglobulin, serum creatinine, glycosylation Hemoglobin, blood glucose, blood urea nitrogen, serum creatinine clearance and blood pressure. Results After treatment, the urinary albumin and β2-microglobulin in treatment group A and treatment group B were not significantly higher than those before treatment (P> 0.05). One case of microalbuminuria occurred in two groups during treatment, while the control group 6 cases of microalbuminuria, 1 case of clinical proteinuria. Before and after treatment, the clearance rate of blood and liver, blood urea nitrogen and blood muscle liver of group A and group B had no significant changes (P> 0.05), while those in control group increased significantly (P <0.01). The levels of urine microalbumin and β2-microglobulin in the control group were significantly increased after treatment (P <0.01). Three groups of blood glucose, glycosylated hemoglobin, blood pressure before and after treatment no significant difference (P> 0.05). Conclusion benazepril can significantly reduce urinary microalbumin and β2-microglobulin, protect renal function, streptomycin nephrotoxicity have a more obvious protective effect, worthy of clinical promotion.