阿托伐他汀联合厄贝沙坦治疗高血压肾病患者的效果及对肾功能的影响

Effect of Atorvastatin Combined with Irbesartan in the Patients with Hypertensive Nephropathy and Its Influence on Renal Function

目的:分析阿托伐他汀联合厄贝沙坦治疗高血压肾病患者的效果及对肾功能的影响。方法:选取2020年1-12月本院收治的96例高血压肾病患者,根据治疗方案将其分为研究组(n=56)和对照组(n=40)。两组患者均进行高血压肾病的常规治疗,对照组在常规治疗的基础上实施厄贝沙坦治疗,研究组在对照组基础上加用阿托伐他汀治疗。比较两组患者的临床疗效及不良反应发生情况,比较治疗前后的血压(收缩压、舒张压)、血脂[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、肾功能[24 h尿蛋白定量、β2-微球蛋白(β2-MG)、尿素氮(BUN)、血清肌酐(Scr)]、炎症因子指标[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]。结果:治疗前,两组舒张压、收缩压、24 h尿蛋白定量、β2-MG、BUN、Scr比较,差异均无统计学意义(P>0.05);治疗后,两组舒张压、收缩压、24 h尿蛋白定量、β2-MG、BUN、Scr均低于治疗前,且研究组均低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组TC、TG、HDL-C、LDL-C、IL-6、TNF-α、hs-CRP比较,差异均无统计学意义(P>0.05);治疗后,两组TC、TG、HDL-C、LDL-C、IL-6、TNF-α、hs-CRP均优于治疗前,且研究组均优于对照组,差异均有统计学意义(P<0.05)。研究组总有效率为96.43%高于对照组的80.00%,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:阿托伐他汀与厄贝沙坦联合治疗对血压水平的控制可起到较为积极的意义,且对患者的血脂指标、肾功能、炎症状态均有改善作用,安全性较好,临床应用价值较高。

Objective:To analyze the effect of Atorvastatin combined with Irbesartan in patients with hypertensive nephropathy and its influence on renal function.Method:A total of 96 patients with hypertensive nephropathy admitted to our hospital from January 2020 to December 2020 were selected,they were divided into study group (n=56) and control group (n=40) according to treatment options.Both groups received routine treatment for hypertensive nephropathy,and the control group received Irbesartan on the basis of the routine treatment,and the study group received Atorvastatin on the basis of the control group.The clinical efficacy and the occurrence of adverse reactions were compared between two groups,the blood pressure (systolic blood pressure,diastolic blood pressure),blood lipid[total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C)]and renal function[24 h urinary protein quantitative,β2-microglobulin (β2-MG),urea nitrogen (BUN),serum creatinine (Scr)],inflammatory factor indicators[hs-CRP,tumor necrosis factor-α(TNF-α),interleukin-6 (IL-6)]before and after treatment were compared between two groups.Result:Before treatment,there were no significant differences in diastolic blood pressure,systolic blood pressure,24 h urinary protein quantitative,β2-MG,BUN and Scr between two groups (P>0.05);after treatment,the diastolic blood pressure,systolic blood pressure,24 h urinary protein quantitative,β2-MG,BUN,Scr of two groups were lower than those before treatment,and those of the study group were lower than those of the control group,the differences were statistically significant (P<0.05).Before treatment,there were no significant differences in TC,TG,HDL-C,LDL-C,IL-6,TNF-α and hs-CRP between two groups (P>0.05);after treatment,TC,TG,HDL-C,LDL-C,IL-6,TNF-α and hs-CRP of two groups were superior than those before treatment,and those of the study group were superior than those of the control group,the differences were statistically significant (P<0.05).The total effective rate of the study group was 96.43%,higher than 80.00% of the control group,the difference was statistically significant (P<0.05).There was no significant difference in the incidence of adverse reactions between two groups (P>0.05).Conclusion:The combined treatment of Atorvastatin and Irbesartan can play a positive role in the control of blood pressure level,and can improve the blood lipid index,renal function and inflammatory status of patients,which has good safety and high clinical application value.