丹参酮ⅡA磺酸钠联合厄贝沙坦对高血压合并肾损伤患者尿NAG、β_(2)-MG、血清PICP及PCX水平的影响

Effects of tanshinone ⅡA sodium sulfonate injection combined with Irbesartan on urinary NAG, β-MG,serumPICP and PCX levels in patients with hypertensive complicated by kidney injury

目的探讨丹参酮ⅡA磺酸钠联合厄贝沙坦对高血压合并肾损伤患者尿N-乙酰-β-D-葡萄糖苷酶(NAG)、β_(2)-微球蛋白(β_(2)-MG)、血清I型前胶原羧基末端前肽(PICP)及足细胞标记蛋白(PCX)水平的影响。方法选取2017年1月—2019年6月沈阳市某医院收治的94例高血压合并肾损伤患者为研究对象,采用随机数字表法将患者分为观察组和对照组,每组47例。对照组患者给予厄贝沙坦(150 mg/d)口服治疗,观察组患者在对照组治疗基础上给予丹参酮ⅡA磺酸钠注射液(50 mg/d)静脉推注,共治疗8周。比较2组患者治疗前后血压、PICP、PCX水平,血清尿素氮和肌酐水平,尿NAG、β_(2)-MG和尿微量白蛋白(m ALB)水平,同时比较2组患者不良反应发生情况。结果治疗前,2组患者收缩压、舒张压、尿素氮、肌酐、血清PICP、PCX水平、尿m ALB、NAG和β_(2)-MG水平比较,差异均无统计学意义(P>0.05)。治疗后,2组患者收缩压、舒张压、尿素氮、肌酐、血清PICP、PCX、尿m ALB、NAG和β_(2)-MG水平均低于治疗前,且观察组患者明显低于对照组,差异均有统计学意义(P<0.05)。对照组患者在治疗期间共发生不良反应8例,不良反应发生率为17.02%;观察组患者在治疗期间共发生不良反应4例,不良反应发生率为8.51%;2组不良反应发生率比较,差异无统计学意义(χ^(2)=1.528,P=0.216)。结论丹参酮ⅡA磺酸钠联合厄贝沙坦可有效降低高血压合并肾损伤患者的血压、血清及尿液中肾损伤标志物水平,改善高血压合并肾损伤患者的肾功能,且不良反应少,值得临床推广应用。

Objective To investigate the effects of tanshinoneⅡA sulfonate sodium injection on the urinary N-ace-tyl-β-D-glucosidase(NAG),β_(2)-microglobulin(β_(2)-MG),serum procollagen type Ⅰ carboxy-terminal propeptide(PICP),and podocyte marker protein podocalyxin(PCX)levels in patients with hypertensive complicatedby kid-ney injury.Methods Ninety-four patients with hypertension complicated by kidney injury admitted to a hospital in Shenyang from January 2017 to June 2019 were selected for the study,and the patients were divided into ob-servation and control groups using the randomized grouping method,with 47 cases in each group.Patients in the control group were given irbesartan(150 mg/d)orally,and patients in the observation group were given tanshi-noneⅡA sulfonate sodium injection(50 mg/d)intravenously on the basis of the treatment in the control group for a total of 8 weeks.The blood pressure,serum PICP and PCX levels,serum urea nitrogen and creatinine lev-els,urinary NAG,β_(2)-MG,and microalbumin(m ALB)levels of the two groups were compared before and after treatment,and the occurrence of adverse reactions was compared between the two groups.Results Before treat-ment,there were no statistically significant differences in systolic and diastolic blood pressure,serum urea nitro-gen and creatinine levels,serum PICP and PCX levels,and serum urinary m ALB,NAG,andβ_(2)-MG levels be-tween the two groups(P>0.05).After treatment,the systolic and diastolic blood pressure,serum urea nitro-gen and creatinine levels,serum PICP and PCX levels,serum urinary m ALB,NAG,andβ_(2)-MG levels were sig-nificantly lower than those before treatment in both groups,and those in the observation group were significantly lower than the control group(P<0.05).In the control group,8 cases of adverse reactions occurred during the treatment,and the incidence of adverse reactions was 17.02%;in the observation group,4 cases of adverse reac-tions occurred during the treatment,and the incidence of adverse reactions was 8.51%;the incidence of adverse reactions between the two groups(χ^(2)=1.528,P=0.216).Conclusion TanshinoneⅡA sodium sulfonate com-bined with irbesartan can effectively reduce blood pressure and the levels of kidney injury markers in serum and urine among patients with hypertensive complicated by kidney injury and improve their renal function with few ad-verse reactions.Therefore,it is worthy of clinical promotion and application.