缬沙坦对慢性肾衰竭合并高血压患者血浆内皮素的影响及临床意义

The Effect of Valsartan on the Plasma Endothelin of Patients With Chronic Renal Failure Complicating Hypertension Patients and Its Clinical Significance

目的:观察缬沙坦对慢性肾衰竭（CRF）合并高血压患者血浆内皮素（ET）、降钙素基因相关肽（CGRP）含量、尿蛋白和Q-T离散度（Q-Td）的影响。方法:将慢性肾衰竭患者分为血压升高组（研究组）24人,口服缬沙坦80mg/d,共治疗4wk;血压正常组（对照组）20人,健康对照组9人,分别测定研究组用药前、后与对照组及健康组的血浆ET和CGRP含量、24h尿蛋白定量及Q-Td。结果:（1）CRF患者血浆ET含量均高于健康组,且CRF研究组高于CRF对照组,药物治疗后ET含量下降;（2）CRF患者血浆CGRP含量高于健康组,且CRF研究组高于CRF对照组,药物治疗后CGRP含量明显升高;（3）CRF患者尿蛋白高于健康组,且 CRF研究组高于对照组,药物治疗后尿蛋白减少;（4）CRF患者合并高血压后 Q-Td明显比对照组及健康组延长,药物治疗后无明显改变。结论:缬沙坦可治疗CRF合并高血压患者,有效降血压、降尿蛋白,延缓肾功能恶化,但无逆转心血管重塑的作用。

OBJECTIVE:To observe the influence of Valsartan on the serum ET,CGRP levels,urinary protein and Q - Td of patients with CRF complicating hypertension.METHODS: CRF research group including 24 patients with CRF complicating hypertension receiving Valsartan 80mg/ d for 4 weeks; CRF control groups including 20 CRF patients with normal blood pressure; health group including 9 health people.The serum ET and CGRP levels, urinary protein, and Q - Td were measured.RESULTS: (l)The serum ET level of CRF patients was higher than that of health people;The serum ET level of CRF research group(before treatment) was higher than that of CRF control group and decreased after treatment of Valsartan.(2) The serum CGRP level of CRF patients was higher than that of health people .The serum of CGRP level of CRF research group (before treatment) was higher than that of CRF control group and continued to increase after treatment of Valsartan. (3) The content of urinary protein of CRF patients was significantly higher than that of health people.The content of urinary protien of CRF research group before treatment was higher than that of CRF control group and decreased after treatment of Valsartan. (4) The Q - Td of CRF research group was longer than that of health group and CRF control group.But the Q - Td of CRF research group did not change after treatment of Valsartan.CONCLUSION: Valsartan could effectively control blood pressure and decrease content of urinary protein, and delay the deterioration of renal function, but could not reverse the cardiovascular remoulding.