福辛普利钠联合多沙唑嗪治疗对肾性高血压患者血压控制及相关生物活性因子的影响

Effects of fosinopril sodium combined with doxazosin on blood pressure control and related bioactive factors in patients with renal hypertension

目的探讨福辛普利钠与多沙唑嗪联合对肾性高血压的治疗效果,并分析治疗后患者血压控制情况及相关活性因子变化。方法前瞻性选取天津市北辰区北辰医院2020年10月—2023年10月收治的98例肾性高血压患者,以随机数字表法作为分组方式,分为观察组(n=49)与对照组(n=49)。对照组患者采取福辛普利钠治疗,观察组在对照组基础上增加多沙唑嗪治疗。对比两组的血压控制效果,治疗前后一氧化氮(NO)、内皮素(ET)、血管紧张素Ⅱ(AngⅡ)相关生物活性因子水平变化,肾功能变化,不良反应发生情况。结果观察组总有效率89.79%,高于对照组的73.47%(χ^(2)=4.356,P=0.037);治疗后两组AngⅡ、ET水平均降低,且观察组[(13.62±2.24)ng/mL、(68.62±6.66)ng/L]低于对照组[(16.25±4.32)ng/mL、(74.26±9.35)ng/L],对比差异有统计学意义(t_(1)=3.783,t_(2)=3.439,P<0.001);NO水平升高,观察组[(54.26±3.42)μmol/L]高于对照组[(50.51±2.37)μmol/L],对比差异有统计学意义(t=6.309,P<0.001);治疗后两组血肌酐(Scr)、尿素氮(BUN)、胱抑素C(CysC)水平均降低,且观察组[(404.36±92.12)μmoI/L、(13.34±4.31)mmol/L、(2.19±0.24)mg/L]低于对照组[(443.49±80.19)μmoI/L、(15.07±4.23)mmol/L、(2.87±0.38)mg/L],对比有统计学意义(t_(1)=2.243,P_(1)=0.027;t_(2)=2.005,P_(2)=0.048;t_(3)=10.591,P_(3)<0.001);两组不良反应发生率对比差异无统计学意义(10.20%vs 8.16%,P>0.05)。结论对肾性高血压患者,采取福辛普利钠与多沙唑嗪联合治疗可提升其血压控制效果,改善血管内皮功能,降低血管紧张素Ⅱ表达水平,改善肾功能,且不增加不良反应。

Objective To explore the therapeutic effect of the combination of fosinopril sodium and doxazosin on renal hypertension,and to analyze the blood pressure control and changes in related active factors in patients after treatment.Methods A prospective study was conducted on 98 patients with renal hypertension admitted to Beichen Hospital from October 2020 to October 2023.Random number table method was used as the grouping method,and they were divided into an observation group(n=49)and a control group(n=49).The control group patients were treated with fosinopril sodium,while the observation group was treated with doxazosin additionally.The blood pressure control effect,changes in levels of NO,ET,AngⅡ related bioactive factors,renal function changes before and after treatment,and their adverse reactions were compared.Results The total response rate in the observation group was 89.79%,which was higher than 73.47% in the control group(χ^(2)=4.356,P=0.037).AngⅡ and ET levels in both groups decreased after treatment,the observation group[(13.62±2.24)ng/mL,(68.62±6.66)ng/L]was lower than the control group[(16.25±4.32)ng/mL,(74.26±9.35)ng/L],the difference was statistically significant(t1=3.783,t2=3.439,P<0.001).Elevated NO levels in the observation group[(54.26±3.42)μmol/L]was higher than the control group[(50.51±2.37)μmol/L],the difference was statistically significant(t=6.309,P<0.001).Blood Scr,BUN,and CysC levels were decreased in both treatment groups,and those in observation group[(404.36±92.12)μmoI/L,(13.34±4.31)mmol/L,(2.19±0.24)mg/L]were lower than the control group[(443.49±80.19)μmoI/L,(15.07±4.23)mmol/L,(2.87±0.38)mg/L],the differences were statistically significant(t_(1)=2.243,P_(1)=0.027;t_(2)=2.005,P_(2)=0.048;t_(3)=10.591,P_(3)<0.001;P<0.05).There was no difference in the incidence of adverse effects between the two groups(10.20%vs 8.16%,P>0.05).Conclusions The combination treatment of fosinopril sodium and doxazosin can improve the blood pressure control effect,improve endothelial function,reduce the expression level of angiotensin Ⅱ,and improve renal function in patients with renal hypertension,with high safety.