丹参川芎嗪联合前列地尔对高血压早期肾损害的疗效

Curative effect of Danshen Chuanxiongqin Injection combining alprostadil on early renal damage in patients with hypertension

目的：探讨丹参川芎嗪联合前列地尔对原发性高血压患者早期肾损害的疗效。方法选择2011年12月至2013年11月在肇庆医专附属医院心内科住院的轻、中度原发性高血压伴早期肾损害患者120例，其中男性62例，女性58例，年龄33~78岁。所有患者随机分为A组，B组，C组，每组40例。所有患者均予缬沙坦降压治疗，A组加用丹参川芎嗪注射液，B组加用前列地尔注射液，C组同时给予丹参川芎嗪和前列地尔静脉滴注。3组患者连续治疗2周。检测治疗前后血糖、血脂，血清α1-微球蛋白和血清、尿β2-微球蛋白，血管指数和阻力指数。结果与治疗前比较，A组、B组和C组连续治疗2 w后，血清α1-微球蛋白、血清β2-微球蛋白和尿β2-微球蛋白水平均降低，差异具有统计学意义（P均＜0.05）。与A组治疗后比较，C组治疗后血清α1-微球蛋白[（21.3±3.97）mg/L vs.（16.7±3.49）mg/L]、血清β2-微球蛋白[（3136.5±310）μg/L vs.（2557.6±275.8）μg/L]和尿β2-微球蛋白[（138.2±13.8）μg/L vs.（109.7±13.6）μg/L]水平均降低，差异具有显著统计学意义（P均＜0.01）。与B组治疗后比较，C组治疗后血清α1-微球蛋白[（21.9±3.88）mg/L vs.（16.7±3.49）mg/L]、血清β2-微球蛋白[（3188.6±298.7）μg/L vs.（2557.6±275.8）μg/L]和尿β2-微球蛋白[（139.3±14.2）μg/L vs.（109.7±13.6）μg/L]水平均降低，差异具有显著统计学意义（P均＜0.01）。与A组治疗后比较，C组治疗后血管指数[（31.3±7.07） vs.（35.7±7.26）]升高，阻力指数[（0.60±0.05） vs.（0.51±0.04）]降低，差异具有统计学意义（P均＜0.05）。与B组治疗后比较，C组治疗后血管指数[（31.1±7.12） vs.（35.7±7.26）]升高，阻力指数[（0.61±0.05） vs.（0.51±0.04）]降低，差异具有统计学意义（P均＜0.05）。结论丹参川芎嗪、前列地尔均能减轻高血压早期肾损害，两者联用，效果优于单独使用。

Objective To investigate the curative effect of Danshen Chuanxiongqin Injection combining alprostadil on early renal damage in patients with primary hypertension. Methods The patients （n=120, male 62 and female 58, aged from 33 to 78） with mild or moderate primary hypertension and early renal damage were randomly divided into group A, group B and group C （each n=40）. All patients were treated with valsartan, and group A was additionally given Danshen Chuanxiongqin Injection, group B, alprostadil injection and group C, Danshen Chuanxiongqin Injection and alprostadil injection for 2 w. The changes of blood glucose, blood fat,α1-microglobulin （α1MG） in serum,β2-microglobulin （β2MG） in serum and urine, vascular index and resistance index were detected before and after treatment. Results After treatment for 2 w,α1MG in serum andβ2MG in serum and urine decreased in 3 groups （all P〈0.05）. Compared with group A, serumα1MG [（21.3±3.97） mg/L vs. （16.7±3.49） mg/L], serumβ2MG [（3136.5±310）μg/L vs. （2557.6±275.8）μg/L] and urinaryβ2MG [（138.2± 13.8）μg/L vs. （109.7±13.6）μg/L, all P〈0.01] all decreased in group C. Compared with group B, serumα1MG [（21.9±3.88） mg/L vs. （16.7±3.49） mg/L], serumβ2MG [（3188.6±298.7）μg/L vs. （2557.6±275.8）μg/L] and urinaryβ2MG [（139.3±14.2）μg/L vs. （109.7±13.6）μg/L, all P〈0.01] all decreased in group C. Compared with group A, vascular index increased [（31.3±7.07） vs. （35.7±7.26）], and resistance index decreased [（0.60± 0.05） vs. （0.51±0.04）, all P〈0.05] in group C. Compared with group B, vascular index increased [（31.1±7.12） vs. （35.7±7.26）], and resistance index decreased [（0.61±0.05） vs. （0.51±0.04）, all P〈0.05] in group C. Conclusion Danshen Chuanxiongqin Injection and alprostadil all can relieve early renal damage in hypertensive patients, and combination of them will has better curative effect.