عنوان المقالة:ﺗﻘﻴﻴﻢ ﻓﻌﺎﻟﻴﺔ اﻟﻜﺎﻧﺪﻳﺴﺎرﺗﺎن، دﻳﻠﺘﻴﺎزﻳﻢ، أو ﻛﻠﻴﻬﻤﺎ ﻋﻠﻰ ﻣﺴﺘﻮﻳﺎت اﻷﻟﺒﻮﻣﻴﻦ ذات اﻟﺘﺮﻛﻴﺰ اﻟﻘﻠﻴﻞ، أو اﻟﺘﺮﻛﻴﺰ اﻟﻄﺒﻴﻌﻲ او اﻟﺘﺮﻛﻴﺰ اﻟﻌﺎﻟﻲ ﻓﻲ اﻹدرار ﻓﻲ ﻣﺮﺿﻰ اﻟﺴﻜﺮي ﻣﻦ اﻟﻨﻮع اﻟﺜﺎﻧﻲ Evaluation of the effectiveness of candesartan, diltiazem, or their combination on normo-, micro- and macroalbuminuria in type 2 diabetic patients.
د.عبير مظفر الحميضي | Dr. Abeer Mudhafar Al-Humaidhie | 9043
- نوع النشر
- مجلة علمية
- المؤلفون بالعربي
- ﻋﺒﻴﺮ ﻣﻈﻔﺮ ﻋﺒﺪ اﻟﺮﺣﻤﻦ, ﺟﻮاد ﺣﺴﻦ اﺣﻤﺪ, ﺣﻴﺪر ﺻﺎﻟﺢ ﻋﺒﻮد
- المؤلفون بالإنجليزي
- Abeer M. Abdulrahman, Jawad H. Ahmed, Haider S Abood
- الملخص العربي
- اﻟﺨﻼﺻﺔ:ﺛﻠﺚ ﻣﺮﺿﻰ اﻟﺴﻜﺮي ﻳﺘﻌﺮﺿﻮن ﻓﻲ ﻧﻬﺎﻳﺔ اﻟﻤﻄﺎف اﻟﻰ اﻋﺘﻼل اﻟﻜﻠﻴﺔ .وﻳﻌﺘﺒﺮ اﻷﻟﺒﻮﻣﻴﻦ ذات اﻟﺘﺮﻛﻴﺰ اﻟﻘﻠﻴﻞ ﻓﻲ اﻹدرار (ﻣﻦ اﻟﻌﻼﻣﺎت اﻟﻤﺒﻜﺮة ﻷﻋﺘﻼل اﻟﻜﻠﻴﺔ اﻟﺴﻜﺮي و ﻗﻴﺎﺳﻪ إﻟﺰاﻣﻲ ﻟﻠﻮﻗﺎﻳﺔ اﻟﻤﺒﻜﺮة ﻣﻦ اﻟﻔﺸﻞ اﻟﻜﻠﻮي وان اﻷدوﻳﺔ اﻟﺘﻲ ﺗﻤﻨﻊ ﻇﻬﻮر اﻷﻟﺒﻮﻣﻴﻦ ذات اﻟﺘﺮﻛﻴﺰ MIA) اﻟﻘﻠﻴﻞ ﻓﻲ اﻹدرار ﻗﺪ ﺗﺆﺧﺮ ﺗﺪﻫﻮر وﻇﻴﻔﺔ اﻟﻜﻠﻰ. . (ﻓﻲ اﻷدرار ﻓﻲ ﻣﺮﺿﻰ اﻟﺴﻜ ﺮي MIA) اﻟﻬﺪف :ﻟﺘﻘﻴﻴﻢ ﻓﻌﺎﻟﻴﺔ اﻟﻜﺎﻧﺪﻳﺴﺎرﺗﺎن، دﻳﻠﺘﻴﺎزﻳﻢ، أو ﻛﻠﻴﻬﻤﺎ ﻋﻠﻰ ﻣﺮﻳﻀﺎ ﻟﺪﻳﻬﻢ ٦٤ ﻣﺮﻳﺾﻣﺼﺎب ﺑﺎﻟﺴﻜﺮي اﻟﺬﻳﻦ ﺣﻀﺮوا اﻟﻌﻴﺎدة اﻟﺨﺎرﺟﻴﺔ ﻓﻲ اﻟﻤﺴﺘﺸﻔﻴﺎت اﻟﻤﺤﻠﻴﺔ ﻓﻲ ﻣﺪﻳﻨﺔ اﻟﺒﺼﺮةﻟﻠﺪراﺳﺔ، وﻛﺎن ١٠٤ اﻟﻤﻨﻬﺠﻴﺔ :ﺗﻢ ﺗﺠﻨﻴﺪ ﻣﺮﻳﻀﺎ ﻟﺪﻳﻬﻢ ﺗﺮﻛﻴﺰ ﻣﻌﺘﺪل ﻟﻸﻟﺒﻮﻣﻴﻦ ﻓﻲ اﻷدرار .وﺗﻢ ﺗﻘﺴﻴﻢ ﻛﻞ ﻣﺠﻤﻮﻋﺔ إﻟﻰ ﺛﻼث ﻣﺠﻤﻮﻋﺎت ﻓﺮﻋﻴﺔ؛ وﻋﻮﻟﺠﺖ ﻛﻞ ﻣﺠﻤﻮﻋﺔ ﻓﺮﻋﻴﺔ ﺑﺎﻷدوﻳﺔ ٤٠ (، وMIA) ،HbA1c ﻣﻠﻐﻢ دﻳﻠﺘﻴﺎزﻳﻢ، أو اﻟﺠﻤﻊ ﺑﻴﻨﻬﻤﺎ ﻟﻤﺪة ﺳﺘﺔ أﺷﻬﺮ .وﺗﻢ ﻗﻴﺎس اﻟﺒﻮل اﻟﺰﻻﻟﻲ، ﻧﺴﺒﺔ اﻟﺴﻜﺮ ﻓﻲ اﻟﺪم، ﻧﺴﺒﺔ ٩٠ﻣﻠﻐﻢ ﻛﺎﻧﺪﻳﺴﺎرﺗﺎن، 8 :اﻷﺗﻴﺔ أﺷﻬﺮ ﻣﻦ اﻟﻌﻼج .اﻟﻨﺘﺎﺋﺞ :أدى اﺳﺘﻌﻤﺎل اﻟﻜﺎﻧﺪﻳﺴﺎرﺗﺎن ، دﻳﻠﺘﻴﺎزﻳﻢ ٦و ٣ اﻟﻜﺮﻳﺎﺗﻴﻨﻴﻦ، واﻟﺒﻮﺗﺎﺳﻴﻮم ﻓﻲ ﻣﺼﻞ اﻟﺪم، و اﻟﻜﻮﻟﻴﺴﺘﺮول اﻟﻜﻠﻲ وﺿﻐﻂ اﻟﺪم ﺑﻌﺪ أﺷﻬﺮ ﻣﻦ اﻟﻌﻼج ﺑﺎﻟﻤﻘﺎرﻧﺔ ﻣﻊ اﻟﻤﺴﺘﻮﻳﺎت ﻗﺒﻞ اﻟﻌﻼج .وﻗﺪ أدى اﺳﺘﻌﻤﺎل ٦و ٣ (ﻓﻲ ﻧﻬﺎﻳﺔ MIA)واﻟﺠﻤﻊ ﺑﻴﻨﻬﻤﺎ إﻟﻰ ﻧﻘﺼﺎن ﻛﺒﻴﺮ ﻳﻌﺘﺪ ﺑﻪ اﺣﺼﺎﺋﻴﺎ ﻓﻲ أﺷﻬﺮ ﻣﻦ ٦و ٣ﺑﻌﺪ ٣٢.٥ ± ٤٠.١و ٥٧.٤ ± ٧٦.٧ ﻣﻴﻜﺮوﻏﺮام /ﻣﻞ ﻗﺒﻞ اﻟﻌﻼج إﻟﻰ ١٣٤ ± ١٧٥.٨ (ﻣﻦ MIA) ﻛﺎﻧﺪﻳﺴﺎرﺗﺎن اﻟﻰ إﻧﻘﺎص ٣٧.٦ ±٥١.٠و ٥٢.٦ ±٦٧.٢ ﻣﻴﻜﺮوﻏﺮام/ﻣﻞ إﻟﻰ ١٠٢.٨ ±١٢٢.٢ (ﺑﺎﺳﺘﻌﻤﺎل اﻟﺪﻳﻠﺘﻴﺎزﻳﻢ ﻣﻦ MIA) اﻟﻌﻼج ﻋﻠﻰ اﻟﺘﻮاﻟﻲ .وﺣﺪث اﻧﺨﻔﺎض ﻓﻲ ٦٧.٢ ±٩٣.٢ ﻣﻴﻜﺮوﻏﺮام /ﻣﻞ إﻟﻰ ١٠٦.٤ ±١٧٤.٦ (ﻣﻦ MIA) أﺷﻬﺮ ﻋﻠﻰ اﻟﺘﻮاﻟﻲ .وأدى اﺳﺘﻌﻤﺎل اﻟﻌﻼﺟﻴﻦ ﻣﻌﺎ إﻟﻰ اﻧﺨﻔﺎض ﻓﻲ ٦و ٣ﻓﻲ ﻧﻬﺎﻳﺔ (ﻓﻲ اﻟﻤﺠﺎﻣﻴﻊ اﻟﺜﻼﺛﺔ ﻗﻠﻴﻼ .ﻟﻘﺪ ادى MIA) .إﻣﺎ ﻓﻲ اﻟﻤﺮﺿﻰ اﻟﺬﻳﻦ ﻟﺪﻳﻬﻢ اﻟﺘ ﺮﻛﻴﺰ اﻟﻤﻌﺘﺪل ﻟﻸﻟﺒﻮﻣﻴﻦ ﻓﻲ اﻷدرار، ﻓﻘﺪ ﻛﺎن ﻧﻘﺼﺎن ٥٣.٠ ± ٤٦.١و اﺳﺘﻌﻤﺎل اﻷدوﻳﺔ إﻟﻰ اﻧﺨﻔﺎض ﻓﻲ ﺿﻐﻂ اﻟﺪم وﻟﻜﻦ ﻟﻢ ﻳﺼﻞ إﻟﻰ درﺟﺔ ﻫﺒﻮط اﻟﻀﻐﻂ.اﻻﺳﺘﻨﺘﺎﺟﺎت :أدى اﺳﺘﻌﻤﺎل ﻛﺎﻧﺪﻳﺴﺎرﺗﺎن، دﻳﻠﺘﻴﺎزﻳﻢ، او اﻟﺠﻤﻊ ﺑﻴﻨﻬﻤﺎ اﻟﻰ ﻧﻘﺼﺎن اﻷﻟﺒﻮﻣﻴﻦ ﻓﻲ ﻣﺮﺿﻰ اﻟﺴﻜﺮي واﻟﺬﻳﻦ ﻟﺪﻳﻬﻢ اﻟﺒﻮﻣﻴﻦ ذات اﻟﺘﺮﻛﻴﺰ اﻟﻘﻠﻴﻞ واﻟﻄﺒﻴﻌﻲ واﻟﻤﺮﺗﻔﻊ .
- الملخص الانجليزي
- Background: One third of diabetic patients ultimately develop nephropathy. Microalbuminuria (MIA) is an earliest sign for diabetic nephropathy and its measurement is mandatory for early prevention of end stage renal failure. Drugs which prevent development of MIA may delay deterioration of renal function. Aim: To evaluate effectiveness of candesartan, diltiazem or their combination on MIA in diabetic patients. Methodology: 104 diabetic patients attending outpatient clinic at local Basrah hospitals were recruited for the study, 64 patients had MIA, and 40 patients were normoalbuminuric. Each group was subdivided into three subgroups; each subgroup was treated with either candesartan 8 mg, diltiazem 90 mg, or their combination for six months. Albuminuria, FBS, HbA1c, serum creatinine, serum potassium, total cholesterol and blood pressure were measured after 3 and 6 months. Results: candesartan, diltiazem and the combination significantly reduced MIA at the end of 3 and 6 months treatment in comparison to baseline. Candesartan significantly reduced MIA from 175.8 ± 134 µg/ml at baseline to 76.7 ± 57.4 and 40.1 ± 32.5 after 3 and 6 months respectively. Diltiazem reduced MIA from 122.2 ± 102.8 µg/ml to 67.2 ± 52.6 and 51.0 ± 37.6 at the end of 3 and 6 months respectively. The combination reduced MIA from 174.6 ± 106.4 µg/ml to 93.2 ± 67.2 and 46.1 ± 53.0. In normoalbuminuric patients, the reduction with the three treatment modalities from baseline was small. The three treatments reduced blood pressure without causing hypotension. Conclusions: Candesartan, diltiazem, or the combination reduced albuminuria in diabetic patients with normo-, micro- or macroalbuminuria.
- تاريخ النشر
- 02/11/2013
- الناشر
- Basrah University
- رقم المجلد
- 31
- رقم العدد
- 2
- ISSN/ISBN
- 02530759
- الصفحات
- 53-60
- رابط الملف
- تحميل (160 مرات التحميل)
- الكلمات المفتاحية
- candesartan, diltiazem, type 2 diabetic patients, albuminuria