缬沙坦联合前列地尔治疗慢性肾衰竭伴心功能不全的临床研究

Clinical trial of valsartan combined with alprostadil in the treatment of chronic renal failure with heart failure

目的探讨缬沙坦联合前列地尔治疗慢性肾衰竭伴心功能不全的临床研究。方法将慢性肾衰竭伴心功能不全患随机分2组:对照组和试验组,各38例。对照组患口服缬沙坦胶囊80 mg;试验组在对照组基础上静脉滴注前列地尔20μg,持续治疗12周。比较2组患者的临床疗效、血肌酸酐(SCr)及左心射血分数(LVEF)和血浆黏度等,观察药物不良反应(ADR)发生情况。结果对照组的有效率为73.68%,显著低于试验组的92.10%,组间差异有统计学意义(P<0.05)。治疗后,对照组和试验组血SCr分别为(216.57±34.95)和(168.41±32.01)μmol·L-1;LVEF分别为(46.82±6.34)%和(50.27±6.12)%;血浆黏度分别为(2.34±1.20)和(1.72±1.01)mpa·s。上述指标:组间比较比较差异均有统计学意义(均P<0.05)。2组患者在治疗期间未出现任何ADR。结论缬沙坦联合前列地尔治疗慢性肾衰竭伴心功能不全的疗效显著,可改善心肾功能和血液流变学,且安全性较高。

Objective To explore the effect of valsartan combined with alprostadil in the treatment of chronic renal failure with heart failure.Methods Patients with chronic renal failure and cardiac insufficiency were randomly divided into 2 groups: control group and treatment group, 38 cases in each group.The control group received valsartan capsules 80 mg oral;the treatment group received valsartan capsules 80 mg combined with alprostadil 20 μg intravenous infusion, and 2 groups were treated for 12 weeks.The clinical efficacy of 2 groups, levels of serum creatinine(SCr) and left ventricular ejection fraction(LVEF), and plasma viscosity were compared.The adverse drugs reactions(ADR) were explored.Results The effective rate of the control group was 73.68%,it was lower than the treatment group(92.10%), and the difference was statistically significant(P<0.05).After treatment, the levels of blood SCr of the control group and the treatment group were(216.57±34.95)and(168.41±32.01)μmol·L-1;LVEF in the two groups were(46.82±6.34)% and(50.27±6.12)%;the plasma viscosity in the two groups were(2.34±1.20)and(1.72±1.01)mpa·s,and the difference of the factors were statistically significant(all P<0.05).No ADR occurred during the treatment of the two groups.Conclusion Valsartan combined with alprostadil is effective in the treatment of chronic renal failure with cardiac insufficiency,further improving the heart and kidney function and blood rheology with high safety.