替米沙坦对冠心病合并糖尿病肾病肾功能、心功能、炎症反应及血管内皮功能的影响分析

Effect of telmisartan on renal function,cardiac function,inflammatory response and vascular endothelial function in patients with CHD complicated with DN

目的探讨替米沙坦治疗冠心病(CHD)合并糖尿病肾病(DN)患者的临床效果。方法选取88例CHD合并DN患者,采用随机数字表法分为观察组和对照组,各44例,两组患者的基础治疗均保持一致,观察组给予替米沙坦80 mg·d^(-1),对照组给予依那普利10 mg·d^(-1),疗程3个月。结果治疗前,两组患者的血浆内皮素-1(ET-1)、一氧化氮(NO)、白细胞介素-6(IL-6)、基质金属蛋白酶-9(MMP-9)检测值均差异无统计学意义(P>0.05);治疗后,观察组患者的ET-1、IL-6、MMP-9检测值均显著的低于对照组(P<0.05),NO检测值显著的高于对照组(P<0.05);治疗前,两组患者的左室射血分数(LVEF)、左室舒张末期内径(LVEDd)均差异无统计学意义(P>0.05);治疗后,观察组患者的LVEDd值显著的低于对照组(P<0.05),LVEF值显著的高于对照组(P<0.05);治疗前,两组患者的血肌酐(Scr)、24 h尿蛋白值均差异无统计学意义(P>0.05);治疗后,观察组患者的Scr、24 h尿蛋白值均显著的低于对照组(P<0.05)。结论替米沙坦治疗CHD合并DN患者的效果优于依那普利,能够更显著的改善内皮功能、心功能及肾功能。

Objective To study the clinical effect of telmisartan in the treatment of patients with coronary heart disease( CHD) complicated with diabetic nephropathy( DN). Methods Eighty-eight cases with CHD complicated with DN were selected and assigned randomly into the observation group and the control group,44 cases in each group. Basic treatments of the two groups werethe same. The observation group was given 80 mg·d^(-1) telmisartan,and the control group was given 10 mg·d^(-1) enalapril. The course of treatment was 3 months. Results Before treatment,the differencesindetection values of ET-1,NO,IL-6,MMP-9 between the two groups had no statistical significance( P > 0. 05); after treatment,detection values of ET-1,IL-6,MMP-9 of the observation group were significantly lower than those in the control group( P < 0. 05),while detection value of NO was significantly higher than that in the control group( P < 0. 05). Before treatment,the differencesinleft ventricular ejection fraction( LVEF),left ventricular end-diastolic dimension( LVEDd) between the two groups had no statistical significance( P > 0. 05); after treatment,LVEDd of the observation group was significantly lower than that in the control group( P < 0. 05),while LVEF was significantly higher than that in the control group( P <0. 05). Before treatment,the differences of Scr,24 h urine protein value between the two groups had no statistical significance( P >0. 05); after treatment,Scr,24 h urine protein value of the observation group were significantly lower than those in the control group( P < 0. 05). Conclusions The application of telmisartanto treatment of patients with CHD complicated with DN has better curative effect than enalapril,whichcan significantly improve endothelial function,cardiac function and renal function.