·糖尿病肾脏疾病·

　　【摘要】 目的 评价贝那普利治疗我国糖尿病慢性肾脏疾病(CKD)患者的抗蛋白尿作用。 方法　检索PubMed、Cochrane Library、CBM等数据库1989年1月至2011年8月发表的相关随机对照试验(RCT)。由2名研究者根据纳入和排除标准独立筛选文献并提取相关数据。采用Stata 11软件进行统计学分析。 结果　最终纳入22项研究。贝那普利单药治疗(5~20 mg/d)，UAlb降低59.7 mg/d(P<0.01)，蛋白尿降低0.3 g/d(P<0.01)。与血管紧张素受体拮抗剂(ARB)相比，贝那普利降低UAlb(P=0.586)及蛋白尿(P=0.102)作用比较差异无统计学意义。与ARB单药治疗相比，贝那普利联合ARB进一步使UAlb降低18.8 mg/d(P=0.002)，蛋白尿降低0.3 g/d(P<0.01)。 结论　贝那普利可有效降低我国CKD患者的UAlb和蛋白尿。

　　【关键词】贝那普利;血管紧张素转换酶抑制剂;糖尿病慢性肾脏疾病;荟萃分析

The antiproteinuric_effect of_benazepril_on chronic kidney disease in Chinese diabetic patients LIU Bi-cheng, ZHANG Xun, LIN Jin-xiu. Department of Kidney, Zhongda Hospital, Southeast University, Nanjing 210009, China

　　【Abstract】Objective To evaluate the antiproteinuric effect of benazepril in Chinese diabetes patients with chronic kidney disease (CKD). Methods We searched the PubMed, Cochrane Library, CBM, et al. databases from January 1989 to August 2011 for relevant randomized controlled trials. Two investigators independently identified studies according to the predefined selection criteria, and extracted data. Statistical analysis was performed by the use of the Stata 11 software. Results We identified 1326 candidate articles, of which 22 articles enrolling 1856 patients met the selection criteria. The dosage of benazepril was 5~20 mg/d. Benazepril treatment was associated with a significant reduction in albuminuria (weighted mean difference (WMD)=59.7 mg/dl, P<0.01) and proteinuria (WMD=0.3 g/d, P<0.01) from baseline to follow-up. Benazepril was similar to Angiotensin II receptor blocker (ARB) in lowering proteinuria (P=0.102) and albuminuria (P=0.586). Compared to ARB monotherapy, the combination therapy with benazepril was associated with a further significant reduction of 0.3 g/d in proteinuria (P<0.01) and 18.8 mg/d in albuminuria (P=0.002). Cough was common in patients on Benazepril with a prevalence of 7.5%. Conclusion Benazepril is effective in reducing albuminuria/proteinuria in Chinese diabetic patients with CKD.

　　【Key words】Benazepril;Angiotensin-converting enzyme inhibitor (ACEI);Chronic kidney disease (CKD) in diabetes;Meta-analysis