不同降压药对慢性肾脏病患者肾脏和心血管的保护作用

Comparison of vascular and renal effects between valsartan and cilnidipine in patients with chronic kidney disease

目的比较血管紧张素Ⅱ受体阻滞剂缬沙坦和钙离子通道阻滞剂西尼地平对慢性肾脏病早期合并高血压患者的肾脏和心血管的保护作用。方法选取40例慢性肾脏病早期并且合并高血压的患者随机分配接受缬沙坦(20例)和西尼地平(20例)治疗12个月。分别测量治疗前后患者的血压、血清肌酐、肌酐清除率,蛋白尿、颈动脉内膜中层厚度(IMT)、血浆白细胞介素-6、血脂水平。在治疗前,确保分配到两组的病人上述测量指标没有显著差异。结果经过12个月的观察期后,两组患者在血压控制方面无明显差异,然而在血清肌酐、蛋白尿、颈动脉内膜中层厚度、血浆白细胞介素-6、血脂水平方面,氯沙坦组较西尼地平组明显降低上述指标。结论氯沙坦在慢性肾脏病早期合并高血压患者的肾脏和心血管保护方面优于西尼地平。

Objective Objective To compare the protective effects of angiotensin II receptor blocker losartan and calcium channel blockercilnidipine on early stage of chronic kidney disease in patients with renal and cardiovascular .Methods 40 patients with early stage of chronic kidney disease and hypertension patients were randomly assigned to receive losartan (20 cases) and cilnidipine (20 cases) for 12 months.Blood pressure, the levels of serum creatinine, creatinine clearance, urinary protein, carotid artery intima-media thickness (IMT), interleukin(IL)-6, serum lipid of the two groups were measured before and after treatment .Results Before treatment, there were no signif-icant differences of the measurement indexes between the two groups .After 12 months, there was no significant difference of blood pressure between the two groups;however, the levels of serum creatinine , proteinuria, carotid intima-media thickness, IL-6, lipid levels in losartan group were significantly reduced than those of cilnidipine group .Conclusions The effects of losartan in the early stage of chronic kidney disease in patients with renal and cardiovascular protection is better than that of cilnidipine .