ACEI和ARB对慢性肾脏病患者预后的影响分析

Effect analysis of ACEI and ARB on prognosis of patients with chronic kidney disease

目的 研讨血管紧张素转化酶抑制剂(ACEI)和血管紧张素Ⅱ受体拮抗剂(ARB)对慢性肾脏病(CKD)患者预后的影响。方法 选取88例慢性肾脏病患者,随机分成对照组、观察组,各44例。对照组采用ACEI治疗,观察组采用ARB治疗。比较两组的治疗效果、肾功能相关指标、心功能指标、生活质量评分、不良反应发生情况。结果 两组的治疗总有效率均较高(P>0.05)。观察组治疗后的尿素氮(9.25±1.05)mmol/L、血肌酐(142.56±32.08)μmol/L均低于对照组的(12.56±5.25)mmol/L、(252.26±55.16)μmol/L,血肌酐清除率(96.41±2.08)ml/min高于对照组的(88.56±8.25)ml/min(P<0.05)。观察组治疗后的左室收缩末期内径(LVESD)(46.25±1.06)mm、左室舒张末期内径(LVEDD)(50.26±0.36)mm小于对照组的(49.26±5.26)、(57.15±2.56)mm,左室射血分数(LVEF)(44.89±1.08)%高于对照组的(41.26±5.62)%(P<0.05)。观察组治疗后的活力状况、生理职能、情感职能、社会功能评分分别为(68.44±1.54)、(64.99±2.10)、(68.48±2.15)、(62.48±1.08)分,均高于对照组的(59.48±6.50)、(58.48±8.10)、(59.48±8.41)、(59.71±0.36)分(P<0.05)。两组的不良反应发生率均较低(P>0.05)。结论 ACEI和ARB治疗慢性肾脏病均有一定疗效,但ARB更能显著改善患者的肾功能指标与心功能指标,更有助于提升生活质量。

Objective To explore the effect of angiotensin converting enzyme inhibitor(ACEI)and angiotensin receptor blocker(ARB)on prognosis of patients with chronic kidney disease(CKD).Methods 88 patients with chronic kidney disease were randomly divided into a control group and an observation group,with 44 cases in each group.The control group was treated with ACEI,and the observation group was treated with ARB.The therapeutic effect,renal function related indicators,cardiac function indicators,quality of life score and adverse reactions were compared between the two groups.Results The total effective rate of treatment was high in both groups(P>0.05).After treatment,the observation group had urea nitrogen of(9.25±1.05)mmol/L and serum creatinine of(142.56±32.08)μmol/L,which were lower than(12.56±5.25)mmol/L and(252.26±55.16)μmol/L in the control group;the serum creatinine clearance rate of(96.41±2.08)ml/min in the observation group was higher than(88.56±8.25)ml/min in the control group(P<0.05).After treatment,the left ventricular end-systolic diameter(LVESD)and left ventricular end-diastolic diameter(LVEDD)in the observation group were(46.25±1.06)and(50.26±0.36)mm,which were less than(49.26±5.26)and(57.15±2.56)mm in the control group;the left ventricular ejection fraction(LVEF)of(44.89±1.08)%in the observation group was higher than(41.26±5.62)%in the control group(P<0.05).After treatment,the scores of vitality,role-physical,role-emotional and social function in the observation group were(68.44±1.54),(64.99±2.10),(68.48±2.15)and(62.48±1.08)points,which were higher than(59.48±6.50),(58.48±8.10),(59.48±8.41)and(59.71±0.36)points in the control group(P<0.05).The incidence of adverse reactions was low in both groups(P>0.05).Conclusion Both ACEI and ARB have certain efficacy in the treatment of chronic kidney disease,but ARB can significantly improve the renal function and cardiac function indicators of patients,and is more helpful to improve their quality of life.