·糖尿病慢性肾脏疾病·

　　【摘要】 目的 通过观察糖尿病慢性肾脏疾病(CKD)患者厄贝沙坦治疗后血浆脑钠肽前体(NT-proBNP)水平变化，探讨NT-proBNP在CKD患者中的临床意义。 方法 CKD患者114例，根据尿白蛋白/肌酐比值(UACR)分为大量蛋白尿组(UACR≥300μg/mg)54例、微量白蛋白尿组 (30≤UACR<300 μg/mg)60例。另选取53例尿蛋白正常的T2DM患者作为对照(Con)组。所有研究对象给予厄贝沙坦每天150 mg，连续24周。比较各组患者治疗前后血浆NT-proBNP水平变化及其与Cr、UACR的变化关系。 结果 经厄贝沙坦治疗后，CKD患者NT-proBNP明显下降(P

　　【关键词】糖尿病，2型;脑钠肽前体;厄贝沙坦;尿白蛋白/肌酐比值

The change of plasma N-terminal pro-brain natriuretic peptide in level and its clinical significance: Using Irbesartan to treat chronic kidney disease in T2DM patients   HUANG Qi-ya,YANG Cai-xian,MAI Zhi-min,et al. Department of Endocrinology, Qingyuan The People’s Hospital, Qingyuan 511518,China

Corresponding author: YAN Li, E-mail: hfxyl@vip.tom.com

　　【Abstract】 Objective To observe the change of the level of N-terminal pro-brain natriuretic peptide (NT-proBNP) in the T2DM patients with chronic kidney disease (CKD) in order to investigate its clinical significance in T2DM. Methods One hundred and fourteen T2DM patients with chronic kidney disease (CKD) and 53 T2DM patients with normal urine protein were studied. According to the urinary albumin creatinine ratio (UACR), the 114 T2DM patients with CKD were divided into two groups, the macroalbuminuria group, 54 cases with UACR≥300μg/mg, and the microalbuminuria group, 60 cases with 30≤UACR<300μg/mg. All patients were given Irbesartan 150mg every day, continuously for 24 weeks. The plasma levels of NT-proBNP, creatinine (Cr), hemoglobin A1c, and UACR were measured before and after treatment.The change of level of NT-proBNP in each group after treatment and the relationship of the changed level of NT-proBNP with Cr and UACR were analyzed and compared. Results After treatment, the level of NT-proBNP of T2DM patients with CKD is declined significantly. The changed level of NT-proBNP in the patients with CKD is positively related with Cr and UACR (r=0.551, 0.628, P=0.000). Conclusion Irbesartan reduces urine protein of T2DM patients with CKD, at the same time the NT-proBNP level is reduced subsequently. It suggests that NT-proBNP may become an early new marker to diagnose CKD and a supplementary means to evaluate the treatment effect of T2DM patients with CKD.

　　【Key Words】 Diabetes mellitus,type 2; N-terminal pro-brain natriuretic peptide (NT-proBNP); Irbesartan; Urinary albumin creatinine ratio (UACR)