缬沙坦治疗冠心病并慢性肾功能不全的临床疗效及对转化生长因子β_1、内皮素水平的影响评价

Clinical Efficacy of Valsartan in the Treatment of Coronary Heart Disease with Chronic Renal Insufficiency and Its Effect on the Level of Transforming Growth Factor β_1 and Endothelin

目的探讨缬沙坦治疗冠心病并慢性肾功能不全的临床效果,并分析其对内皮素与转化生长因子β1水平的影响。方法方便选择该院2015年3月—2016年7月所收治的82例冠心病并慢性肾功能不全患者作为该次研究病例,对患者进行分组治疗,分组方式按照就诊时间的不同,研究组和对照组各41例,对照组应用常规药物治疗,研究组在此基础上行缬沙坦治疗,对比分析两组患者的临床效果,观察24 h尿蛋白定量、尿素氮、血肌酐以及转化生长因子β1水平(TGF-β1)、内皮素(ET)水平与不良反应发生情况。结果研究组患者的临床总有效率(95.12%)显著高于对照组(73.17%),(χ~2=7.404 7,P=0.006 5),研究组治疗后24 h尿蛋白定量、尿素氮与血肌酐均低于对照组,且治疗后研究组转化生长因子β1水平与ET水平低于对照组,研究组不良反应发生率(4.87%)显著低于对照组(29.26%),两组经χ~2检验,组间差异有统计学意义(χ~2=8.613 4,P=0.003 3)。结论缬沙坦应用在冠心病并慢性肾功能不全中的效果显著,能够有效降低内皮素与TGF-β1水平,改善患者的肾功能,值得临床应用探索。

Objective To investigate the clinical effect of valsartan in the treatment of coronary heart disease with chronic renal insufficiency and to analyze its effect on the levels of endothelin and transforming growth factor β1. Methods 82 patients with coronary heart disease and chronic renal insufficiency admitted in the hospital from March 2015 to July 2016 were convenient selected as the study case. The patients were divided into groups according to the treatment time. 41 patients in the control group were treated with conventional drugs, and the study group was treated with valsartan. The clinical effects were compared between the two groups. 24-hour urinary protein, urea nitrogen, serum creatinine, and transforming growth factor β1 levels of TGF-β1, Endothelin（ET） levels and occurrence of adverse reactions were observed. Results The total clinical effective rate（95.12%） in the study group was significantly higher than that in the control group（73.17%）（χ^2=7.404 7,P=0.006 5）. The urinary protein, urea nitrogen, and serum creatinine at 24 hours after treatment were treated in the study group. All of them were lower than the control group. After treatment, the levels of TGF-β1 and ET in the study group were lower than those in the control group. The incidence of adverse reactions in the study group（4.87%） was significantly lower than that in the control group（29.26%）（χ^2=8.613 4, P =0.003 3）. Conclusion Valsartan is effective in the treatment of coronary heart disease and chronic renal insufficiency. It can effectively reduce the levels of endothelin and TGF-β1 and improve the renal function of patients. It is worthy of clinical application.