The Effects Of Benazepril And Valsartan On Urinary Monocyte Chemoattractant Protein-1 Of Early Diabetic Nephropathy

Objective To study the effects of angiotension Ⅱ convertase inhibitor and angiotensionⅡ receptor angiotension on urinary monocyte chemoattractant protein-1(MCP-1) as well as their clinic significance in human early diabetic nephropathy.Methods 39cases of patients with type2 diabetes and diabetic nephropathy (urinary albumin excretion rate (UAER) is 20-200 μg/min) and without cardopathy, liverish and nephropathy, were divided into 3 groups by random. Group 1 (n=14) was treated with benazepril (10 mg/d). Group 2 (n=13)was treated with valsartant (80 mg/d). And group 3 was treated with combination of benazepril and valsartant. Before treatment and after 8,12 weeks of posttreatment, urnary MCP-1 levels were measured by enzyme-linked immunosorbent assay (ELISA) and UAER were measured by radioimmunoassay. Then comparation of pretreatment and posttreatment was done between the three groups and between individuals in each group.Results(1) After 8 weeks' therapy, there was no significant differences (P>0.05) between the MCP-1 and UAER decrease rate of1 group and that of 2group. The urinary MCP-1 and UAER decrease rates of three treatment groups all have extremely significant increases (p<0.01) in contrast with pretreatment.After 12 weeks' therapy, there was significant differences (P<0.05) between the MCP-1 and UAER decrease rate of 1 group and that of 2group. The urinary MCP-1 and UAER decrease rates of three treatment groups all have extremely significant increases (p<0.01) in contrast with pretreatment.(2) After 8 ,12 weeks' therapy with benazepril and valsartant.,there were positive correlation on decent rate between urinary MCP-1 levels and UAER in human early diabetic nephropathy. Conclusion(1) RAS system was blocked by in the type 2 diabetic patients intercurrent with nephropathy so that urinary MCP-1 level was reduced. These results also showed that combined medicament treatment was better than single medicament treatment.(2) There is a positive correlation between the decrease rate of urinary MCP-1 and that of UAER.