厄贝沙坦、丹参酮ⅡA磺酸钠联合用药对高血压合并糖尿病肾病患者相关指标的影响

Effect of irbesartan combined with tanshinone ⅡA sulfonate on related indexes in patients with hypertension combined with diabetic nephropathy

目的 探讨厄贝沙坦、丹参酮ⅡA磺酸钠联合用药对高血压(HTN)合并糖尿病肾病(DN)患者相关指标的影响。方法 选取2017年1月~2019年1月我院收治的134例HTN合并DN患者,采用随机数字表法分为对照组和观察组,对照组给予厄贝沙坦治疗,观察组在对照组基础上联合丹参酮ⅡA磺酸钠治疗。记录两组患者治疗前后的舒张压(DBP)和收缩压(SBP);比较两组患者治疗前后的空腹血糖(FBG)和糖化血红蛋白(Hb A1c)水平;对两组患者治疗前后的血肌酐(Scr)、血尿素氮(BUN)和24h尿蛋白排泄率(UAER)肾功能相关指标进行监测;比较两组患者治疗前后的血清转化生长因子-β1(TGF-β1)、视黄醇结合蛋白-4(RBP-4)和脂联素(ADPN)表达水平;统计两组患者的临床治疗效果以及治疗期间出现的不良反应总发生率。结果 观察组的总治疗有效率为88.06%,高于对照组的74.63%(P<0.05);观察组治疗后DBP和SBP水平低于对照组(P<0.05);观察组治疗后FBG和Hb A1c水平低于对照组(P<0.05);观察组治疗后Scr、BUN和UAER三项肾功能指标表达水平低于对照组(P<0.05);观察组治疗后血清TGF-β1、RBP-4和ADPN表达水平低于对照组(P<0.05);观察组不良反应总发生率为8.96%,低于对照组的22.39%(P<0.05)。结论 厄贝沙坦、丹参酮ⅡA磺酸钠联合用药治疗HTN合并DN疗效确切,能显著降低血压与血糖水平,改善肾功能及血清指标,安全性高。

Objective To explore effect of irbesartan combined with tanshinoneⅡA sulfonate on related indexes in patients with hypertension(HTN)combined with diabetic nephropathy(DN).Methods A total of 134 patients with HTN and DN who were admitted to the hospital from Jan 2017 to Jan 2019 were enrolled.They were randomly divided into control group and observation group by random number table method.The control group was given irbesartan.On this basis,observation group was given tanshinoneⅡA sulfonate.The diastolic blood pressure(DBP)and systolic blood pressure(SBP)in both groups before and after treatment were recorded.The blood glucose related indexes such as fasting blood glucose(FBG)and glycosylated hemoglobin(HbA1c)before and after treatment were compared between the two groups.The renal function indexes such as serum creatinine(Scr),blood urea nitrogen(BUN)and 24h urinary albumin excretion rate(UAER)in both groups before and after treatment were monitored.The expression levels of serum TGF-β1,RBP-4 and adiponectin(ADPN)before and after treatment were compared between the two groups.The clinical curative effect and total incidence of adverse reactions during treatment in both groups were statistically analyzed.Results The total response rate of treatment in observation group was higher than that in control group(88.06%vs 74.63%,P<0.05).After treatment,DBP and SBP levels in observation group were lower than those in control group(P<0.05),levels of FBG and HbA1c in observation group were lower than those in control group(P<0.05),expression levels of Scr,BUN and UAER in observation group were lower than those in control group(P<0.05),expression levels of serum TGF-β1,RBP-4 and ADPN in observation group were lower than those in control group(P<0.05).The total incidence of adverse reactions in observation group was lower than that in control group(8.96%vs 22.39%,P<0.05).Conclusion The curative effect of irbesartan combined with tanshinoneⅡA sulfonate is significant on HTN combined with DN,which can significantly decrease blood pressure and blood glucose levels,improve renal function and serum indexes,with high safety.