前列环素衍生物联合缬沙坦治疗早期高血压肾病的血生化指标评估

Effects of prostacyclin derivatives combined with valsartan therapy on the blood biochemical indexes in patients with early hypertensive nephropathy

目的:探讨前列环素衍生物联合缬沙坦治疗对早期高血压肾病患者血生化指标水平的影响。方法:2014年12月~2017年3月间在本院接受治疗的高血压肾病患者110例,参照随机数表法将其分为对照组、实验组,各55例。对照组接受缬沙坦治疗,实验组接受前列环素衍生物联合缬沙坦治疗,持续20周。对比两组患者治疗前后肾功能指标、尿蛋白指标、内皮损伤标志物含量的差异。结果:治疗前,两组肾功能指标、尿蛋白指标、内皮损伤标志物含量的差异无统计学意义(P>0.05)。治疗20周后,实验组外周血中肾功能指标血肌酐(SCr)、尿素氮(BUN)、尿酸(UA)、胱抑素C(CysC)的水平较对照组低(P<0.05);尿液中蛋白指标尿微量白蛋白(ALB)、β_2微球蛋白(β_2-MG)、α_1微球蛋白(α_1-MG)的含量较对照组低;外周血中内皮损伤标志物内皮素-1(ET-1)、E-选择素(E-selectin)的含量较对照组低(P<0.05),一氧化氮(NO)、降钙素基因相关肽(CGRP)的含量较对照组高(P<0.05)。结论:早期高血压肾病患者接受前列环素衍生物联合缬沙坦治疗,可有效优化肾功能、减少尿蛋白、缓解血管内皮损伤,提升整体治疗效果。

Objective:To explore the effects of prostacyclin derivatives combined with valsartan therapy on the blood biochemical indexes in patients with early hypertensive nephropathy.Methods:110 patients with hypertensive nephropathy who were treated in the hospital between December 2014 and March 2017 were divided into control group(n=55)and experimental group(n=55)by random number table method.Control group received valsartan therapy,and experimental group received prostacyclin derivatives combined with valsartan therapy,which lasted for 20 weeks.The differences in the contents of renal function indexes,urinary protein indexes and endothelial injury markers were compared between the two groups before and after treatment.Results:Before treatment,the differences in the contents of renal function indexes,urinary protein indexes and endothelial injury markers were not statistically significant between the two groups.After 20 weeks of treatment,renal function indexes SCr,BUN,UA and CysC levels in peripheral blood of experimental group were lower than those of control group;urinary protein indexes ALB,β_2-MG andα1-MG contents were lower than those of control group;endothelial injury markers ET-1 and E-selectin contents in peripheral blood were lower than those of control group whereas NO and CGRP contents were higher than those of control group.Conclusion:Prostacyclin derivatives combined with valsartan therapy can effectively optimize the renal function,reduce the urinary protein and alleviate the vascular endothelial injury in patients with early hypertensive nephropathy and improve the overall therapeutic effect.