舒洛地特、银杏叶及缬沙坦治疗代谢综合征患者微量白蛋白尿的疗效比较

Comparison of the efficiency of sulodexide, ginaton and valsartan treatment on microalbuminuria in patients with metabolic syndrome

目的比较舒洛地特、银杏叶及缬沙坦治疗代谢综合征患者微量白蛋白尿的疗效及安全性。方法90例代谢综合征合并微量白蛋白尿患者随机分为舒洛地特组（SG组，舒洛地特静脉注射治疗）、银杏叶组（GG组，银杏叶静脉注射治疗）、缬沙坦组（VG组，缬沙坦口服），各30例，治疗4周。观察治疗前、后尿微量白蛋白排泄率（UAER）、血小板聚集率（PAR）及血清超敏C反应蛋白（hs—CRP）表达水平。结果3组患者经治疗后UAER、hs—CRP均明显下降（P〈0．001），SG组、GG组疗效优于VG组（P〈0．01）；hs—CRP与UAER呈显著正相关。治疗后SG组、GG组患者PAR和纤维蛋白原水平也有明显降低（P〈0．05）。3组治疗前后比较，肝功能差异均无统计学意义（P〉0．05）。结论与缬沙坦相比，舒洛地特、银杏叶可更有效地减少代谢综合征患者微量白蛋白尿，这可能与后二者能显著抑制炎性反应、减少血小板聚集、降低血浆纤维蛋白原水平有关。

Objective To observe the efficiency and safety of sulodexide, ginaton and valsartan on microalbuminuria in patients with metabolic syndrome. Methods Ninety patients suffered from metabolic syndrome combined with microalbuminuria were randomly divided into 3 groups. Patients in group SG （n = 30） were treated by injecting sulodexide,in group GG （n = 30） injecting ginaton, and in group VG （n = 30） taking valsartan tablets. The levels of urinaty albumin excretion rates （ UAER ） , platelet aggregation ratio （PAR） ,fibrinogen and high sensitivity c-reactive protein （hs-CRP） were detected before and after 4 weeks on corresponding therapy. Results UAER and hs-CRP decreased significantly in all patients of the three groups （P 〈 0. 001 ）. Furthermore, the levels of UAER and hs-CRP in group SG and GG were even more low- er than those in group VG （ P 〈 0.01 ）, and UAER was significantly correlated to with hs-CRP. After treat- ment,PAR and fibrinogen levels in group SG and group GG were significantly lower than those in baseline （P 〈 0. 05 ）. The liver function showed no significant difference before and after treatment in three groups （ P 〉 0.05 ）. Conclusions Compared with valsartan, sulodexide and ginaton are more efficient in reducing UAER in patients with metabolic syndrome,which may be due to their capability to inhibit systemic inflammation, platelet aggregation, and plasma fibrinogen.