瑞舒伐他汀钙片联合厄贝沙坦片治疗老年原发性高血压肾病的临床研究

Clinical trial of rosuvastatin calcium tablets combined with irbesartan tablets in the treatment of elderly primary hypertension nephropathy

目的观察瑞舒伐他汀钙片联合厄贝沙坦片治疗老年原发性高血压肾病的临床疗效和安全性。方法将60例老年高血压肾病患者随机分为对照组30例和试验组30例。对照组予以厄贝沙坦片每次150 mg,qd,口服;试验组在对照组治疗的基础上,予以瑞舒伐他汀钙片每次10 mg,qd,口服。2组患者均治疗12周。比较2组患者的临床疗效、肝功能、肾功能,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为93.33%(28例/30例)和90.00%(27例/30例),差异无统计学意义(P>0.05)。治疗后,试验组和对照组的总胆固醇含量分别为(3.92±0.67)和(5.54±1.33)mmol·L^(-1),三酰甘油分别为(1.61±0.45)和(2.16±0.84)mmol·L^(-1),低密度脂蛋白胆固醇分别为(2.25±0.62)和(2.76±0.84)mmol·L^(-1),血清肌酸酐分别为(75.70±14.87)和(78.16±18.84)μmol·L^(-1),血尿素氮分别为(4.25±0.99)和(5.03±0.97)mmol·L^(-1),24 h尿蛋白定量分别为(56.92±12.67)和(65.54±16.33)μg·24 h^(-1),β_2-微球蛋白分别为(353.65±27.43)和(389.16±27.84)μg·L^(-1),血清胱抑素C分别为(1.25±0.32)和(1.61±0.52)mg·L^(-1),超敏C-反应蛋白分别为(15.45±4.73)和(19.18±5.63)mmol·L^(-1),差异均有统计学意义(均P<0.05)。2组患者的药物不良反应以恶心、呕吐、头痛为主,试验组和对照组的总药物不良反应发生率分别为23.33%和20.00%,差异无统计学意义(P>0.05)。结论瑞舒伐他汀钙片联合厄贝沙坦片治疗老年原发性高血压肾病的临床疗效和安全性与单用厄贝沙坦片相当,但前者可显著改善患者的肝、肾功能。

Objective To observe the clinical efficacy and safety of rosuvastatin calcium tablets combined with irbesartan tablets in the treatment of elderly primary hypertension nephropathy. Methods A total of60 elderly patients with primary hypertension nephropathy were randomly divided into control group and treatment group with 30 cases per group.Control group was given irbesartan tablets 150 mg per time,qd,orally.Treatment group received rosuvastatin calcium tablets 10 mg per time,qd,orally,on the basis of control group. The clinical efficacy,liver function,renal function and adverse drug reactions were compared between two groups. Results After treatment,the total effective rates in treatment and control groups were 93. 33%（ 28 cases/30 cases） and90. 00%（ 27 cases/30 cases） without significant difference（ P 〉0. 05）. After treatment,the main indexes in treatment and control groups were compared： the total cholesterol were（ 3. 92 ± 0. 67） and（ 5. 54 ± 1. 33） mmol·L^（-1）,triglyceride were（ 1. 61 ± 0. 45） and（ 2. 16 ± 0. 84） mmol·L^（-1）,low density lipoprotein cholesterol were（ 2. 25 ± 0. 62）and（ 2. 76 ± 0. 84） mmol·L^（-1）,serum creatinine were（ 75. 70 ± 14. 87） and（ 78. 16 ± 18. 84） μmol·L^（-1）,blood urea nitrogen were（ 4. 25 ± 0. 99） and（ 5. 03 ± 0. 97） mmol·L^（-1）,24 h urinary protein quantitation were（ 56. 92 ± 12. 67） and（ 65. 54 ± 16. 33） μg·24 h^（-1）,β_2-microspheres were（ 353. 65 ± 27. 43） and（ 389. 16 ± 27. 84） μg·L^（-1）,serum cystatin C were（ 1. 25 ± 0. 32） and（ 1. 61 ± 0. 52） mg·L^（-1）,high-sensitivity C-reactive protein were（ 15. 45 ± 4. 73） and（ 19. 18 ± 5. 63） mmol·L^（-1）,the differences were significant（ all P〈 0. 05）. The adverse drug reactions of two groups were based on nausea,vomiting and headache. The incidences of adverse drug reactions in treatment and control groups were 23. 33% and 20. 00% without significant difference（ P〉 0. 05）. Conclusion Rosuvastatin calcium tablets combined with irbesartan tablets in the treatment of primary hypertension nephropathy in the elderly has the same clinical efficacy and safety as that of irbesartan tablet alone,but they can significantly improve the liver and kidney function of patients.