丹参川芎嗪联合前列地尔对慢性肾脏病患者血脂、肾功能、hs-CRP、cTnT和NT-proBNP的影响

Effects of combination salvia miltiorrhiza and ligustrazine on the levels of hs-CRP,cTnT and NT-proBNP in patients with chronic kidney disease

目的观察丹参川芎嗪联合前列地尔对慢性肾脏病(CKD)患者血脂、肾功能、hs-CRP、cTnT和NTproBNP的影响。方法选择2014年4月—2016年4月辽宁省金秋医院肾内科诊治的慢性肾脏病患者100例作为研究对象,采用随机数字表法分为观察组(n=50)和对照组(n=50)。对照组采用常规治疗,观察组在常规治疗的基础上,加用丹参川芎嗪联合前列地尔进行治疗,均14天为1个疗程。比较2组的总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、尿素氮(BUN)、血肌酐(Scr)和尿白蛋白(Upro)、超敏C-反应蛋白(hs-CRP)、心肌肌钙蛋白T(cTnT)和氨基末端脑钠肽前体(NT-proBNP)水平。结果治疗后,观察组总有效率高于对照组(74.0%vs.40.0%,χ~2=11.791,P=0.001);与治疗前比较,2组治疗后TC、TG、LDL-C水平均下降,且观察组较对照组更低(t=6.183、19.119、3.927,P<0.01),HDL--C水平均有所上升,但2组间比较无明显差异(P>0.05);治疗后,2组BUN、SCr和Upro均下降,且观察组较对照组更低(t=8.426、2.629、6.211,P<0.01);治疗后,2组hs-CRP、cTnT和NT-proBNP水平均下降,且观察组较对照组更低(t=2.111、14.834、168.441,P<0.05)。观察组不良反应总发生率明显低于对照组(12.0%vs.28.0%,χ~2=4.000,P=0.046)。结论丹参川芎嗪联合前列地尔治疗慢性肾脏病疗效显著,不良反应发生率低,值得应用推广。

Objective To observe the effects of salvia miltiorrhiza and ligustrazine on the expression of hs-CRP,cTnT and NT-proBNP in patients with chronic kidney disease.Methods One hundred patients of chronic kidney disease who received therapy from April 2014 to April 2016 were selected as research objects,according to random number table method,these patients were divided into the observation group（n=50）and the control group（n=50）.The control group was treated with routine treatment,while the observation group on the basis of conventional treatment used Danshen ligustrazine combined with alprostadil for treatment.Then total cholesterol,triacylglycerol,high density lipoprotein,low density lipoprotein,urea nitrogen,serum creatinine,urinary albumin,highly sensitive C reactive protein,cardiac troponin T,NT-proBNP were compared between groups.Results After treatment,the clinical efficacy of the observation group was significantly better than the control group（74.0%vs.40.0%,x2=11.791,P=0.001）.TC levels were lower in the observation group than in the control group[（5.41＆#177;0.43）mmol/L vs.（5.98＆#177;0.49）mmol/L,t=6.183,P=0.000].TG levels were lower in the observation group than in the control group[（1.32＆#177;0.18）mmol/L vs.（2.22＆#177;0.28）mmol/L,t=19.119,P=0.000）.LDL level was lower in the observation group than in the control group[（3.01＆#177;0.31）mmol/L vs.（3.39＆#177;0.61）mmol/L,t=3.927,P=0.000].HDL-C level of the 2 group were increased,but the difference between the two groups was not obvious[（1.41＆#177;0.09）mmol/L vs.（1.51＆#177;0.49）mmol/L,t=1.419,P=0.159].BUN in observation group was lower than the control group[（12.51＆#177;2.14）μmol/L vs.（16.15＆#177;2.18）μmol/L,t=8.426,P=0.000].Scr in observation group was lower than the control group[（219.52＆#177;98.63）mmol/L vs.（272.12＆#177;101.41）mmol/L,t=2.629,P=0.010].Upro in observation group was lower than the control group[（1.31＆#177;0.54）g/24h vs.（1.89＆#177;0.38）g/24h,t=6.211,P=0.000].hs-CRP levels were lower in the control group than in the control group[（4.94＆#177;1.28）mg/L vs.（5.82＆#177;2.59）mg/L,t=2.111,P=0.037].CTnT levels were lower than those in the control group [（13.46＆#177;1.73）μg/ml vs.（18.96＆#177;1.97）μg/ml,t=14.834,P=0.000].NT-proBNP levels were lower than those in the control group[（5 147.14＆#177;26.79）pg/ml vs.（6 128.74＆#177;31.31）pg/ml,t=168.441,P=0.000].The overall incidence of adverse reactions in the observation group was significantly lower than that in the control group（12.0%vs.28.0%,x2=4.000,P=0.046）.Conclusion Danshen ligustrazine combined with alprostadil in the treatment of chronic kidney disease can effectively reduce the level of hs-CRP,cTnT and NT-proBNP,enhance the clinical efficacy,and reduce the incidence of adverse reactions after treatment,it is worthy promoting the use of it.