苯那普利联合瑞舒伐他汀治疗对老年冠心病合并肾功能不全患者肾功能的影响

Study of the Effect of Benazepril Combined with Rosuvastatin on Renal Function of Elderly Patients of Coronary Artery Disease Complicated with Renal Insufficiency

目的探讨苯那普利联合瑞舒伐他汀治疗对老年冠心病合并肾功能不全患者肾功能的影响。方法选取2011年2月至2014年3月剑阁县中医院收治的冠心病合并肾功能不全患者共127例,依据随机数字表法分为对照组(63例)和观察组(64例)。对照组在常规治疗的基础上应用瑞舒伐他汀长期治疗,给药剂量为10 mg/d;观察组则在常规药物治疗的基础上应用苯那普利联合瑞舒伐他汀长期治疗,苯那普利10 mg/d,瑞舒伐他汀10 mg/d,治疗时间为6个月。分别于治疗前和治疗后6个月对两组患者的血清尿素氮、肌酐、肾素、血管紧张素、醛固酮、超氧化物歧化酶、谷胱甘肽过氧化物酶以及尿蛋白等指标进行测定。结果与治疗前相比,治疗后6个月两组患者、血清尿素氮、肌酐尿蛋白水平均较治疗前显著降低,治疗后观察组血清尿素氮、肌酐、尿蛋白水平显著低于对照组[(8.9±3.1)mmol/L比(10.3±3.7)mmol/L,(116±21)μmol/L比(165±23)μmol/L,(553±23)mg/d比(671±22)mg/d,P<0.05或<0.01];治疗后6个月观察组患者超氧化物歧化酶、谷胱甘肽过氧化物酶显著高于对照组[(161±18)k U/L比(139±23)k U/L;(141±4)k U/L比(121±4)k U/L,P<0.01]。结论苯那普利联合瑞舒伐他汀治疗老年冠心病合并肾功能不全疗效显著,可改善患者肾功能,降低心血管疾病发生率,值得在临床推广应用。

Objective To investigate the effect of benazepril combined with rosuvastatin on renal func- tion of patients of coronary artery disease complicated with renal insufficiency. Methods Total of 127 patients of coronary artery disease complicated with renal insufficiency treated in Jiange County Hospital of Traditional Chinese Medicine from Feb. 2011 to Mar. 2014 were included in this study. They were divided into observation group （n = 64 ） and control group （n = 63 ） according to random number table method. The observation group was treated with rosuvastatin combined benazepril,and the dosage of benazepril was 10 nag/d, the dosage of rosuvastatin was 10 mg/d ,while the control group were treated with rosuvastatin, the dosage of rosuvastatin was 10 mg/d. The treatment course was 6 months. The renal function was investigated before and after 6 months of treatment by measuring the content of serum urea nitrogen ,.creatinine, renin, angiotensin, aldosterone, superoxide dismutase, glutathione peroxidase, and urinary protein. Results Compared with before treatment,the urine protein,serum urea nitrogen and creatinine levels of both groups were significantly reduced（P 〈0. 05 or 〈0. 01 ）. The serum urine protein,urea nitrogen and creatinine levels of the observa- tion group were significantly lower than the control group [ （8. 91 ± 3. 1 ） mmol/L vs （10. 3 ± 3.7 ） mmol/L, （ 116 ± 21 ）μmol/L vs （ 165 ± 23 ） μmol/L, （553 ± 23 ） mg/d vs （671 ± 22） mg/d, P 〈 0. 01 ]. The superoxide dismutase and glutathione peroxidase of the observation group was significantly higher than the control group after 6 months of treatment [ （161 ± 18 ） kU/L vs （139 ± 23 ） kU/L, （141 ±4 ） kU/L vs （121 ± 4 ） kU/L,P 〈 0. 01 ]. Conclusion Benazepril combined with rosuvastatin has significant effect for treatingelderly patients of coronary heart disease complicated with renal insufficiency, which can improve renal function and reduce the incidence of cardiovascular disease, thus is worthy of the clinical application.