氨氯地平并缬沙坦对高血压合并肾损伤患者自主神经功能及血清Rho相关蛋白激酶1的影响

Influence of amlodipine combined valsartan on autonomic nervous function and Rho-associated protein kinase1 in hypertensive patients with renal injury

目的:研究氨氯地平联合缬沙坦治疗对高血压合并肾损伤患者自主神经功能及血清Rho相关蛋白激酶1(ROCK1)水平的影响。方法:选择于我院治疗的94例高血压合并肾损伤患者,随机分为氨氯地平组和联合治疗组(氨氯地平联合缬沙坦治疗),各47例。治疗1个月后分析比较两组患者的临床疗效,治疗前后的血清ROCK1水平以及自主神经功能指标变化情况,不良反应发生率。结果:治疗后,联合治疗组临床总有效率显著高于氨氯地平组(95.74%比82.97%,P=0.045);与治疗前比较,两组治疗后血清ROCK1 [氨氯地平组(3.25±0.32)ng/ml比(1.24±0.45)ng/ml,联合治疗组(3.34±0.35)ng/ml比(0.22±0.15)ng/ml]水平,24hSBP标准差(24hSSD)、24hDBP标准差(24hDSD)、白昼SBP标准差(dSSD)、夜间SBP标准差(nSSD)、夜间DBP标准差(nDSD)均有显著下降(P均=0.001),且联合治疗组上述指标均显著低于氨氯地平组(P均<0.01)。与氨氯地平组比较,治疗后联合治疗组下肢水肿(27.66%比10.63%)、恶心呕吐(27.66%比8.51%)、头晕乏力(23.40%比8.51%)发生率显著降低(P均<0.05)。结论:氨氯地平联合缬沙坦治疗高血压合并肾损伤患者,疗效显著,能够显著降低血清ROCK1水平,改善患者自主神经功能和预后状况。

Objective:To study influence of amlodipine combined valsartan on autonomic nervous function and serum level of Rho-associated protein kinase 1(ROCK1)in hypertensive patients with renal injury.Methods:A total of 94 hypertensive patients with renal injury treated in our hospital were selected,randomly and equally divided into amlodipine group and combined treatment group(received amlodipine combined valsartan),both groups were treated for one month.Serum ROCK1 level and autonomic nervous function indexes before and after treatment,therapeutic effect and incidence of adverse reactions were analyzed and compared between two groups.Results:After treatment,total effective rate of combined treatment group was significantly higher than that of amlodipine group(95.74%vs.82.97%,P=0.045).Compared with before treatment,after treatment,there were significant reductions in serum ROCK1 level[amlodipine group:(3.25±0.32)ng/ml vs.(1.24±0.45)ng/ml,combined treatment group:(3.34±0.35)ng/ml vs.(0.22±0.15)ng/ml],24hSBP standard deviation(24hSSD),24h DBP SD(24hDSD),daytime SBP SD(dSSD),nighttime SBP SD(nSSD)and nDSD in two groups(P=0.001 all),and above indexes of combined treatment group were significantly lower than those of amlodipine group,P﹤0.01 all.Compared with amlodipine group after treatment,there were significant reductions in incidence rates of lower limb edema(27.66%vs.10.63%),nausea and vomiting(27.66%vs.8.51%)and dizziness and weakness(23.40%vs.8.51%)in combined treatment group,P﹤0.05 all.Conclusion:Amlodipine combined valsartan possesses significant therapeutic effect on hypertensive patients with renal injury.It can significantly reduce serum ROCK1 level and improve autonomic nervous function and prognosis in these patients.