血管紧张素系统阻断剂对慢性肾脏疾病患者血清AngⅡ、TGF-β_1水平的影响  

Influnce of angiotensin system blockers on the levels of serum angiotensin Ⅱ and TGF-β_1 in chronic glomerular disease patients

作　　者：张道友[1] 杨沿浪[1] 徐海红[1] 汪裕伟[1] 朱新俭[1] 杨利才[1] 

机构地区：[1]皖南医学院弋矶山医院肾内科,芜湖241001

出　　处：《安徽医学》2007年第4期285-288,共4页Anhui Medical Journal

基　　金：安徽省学术和技术带头人后备人选科学研究基金资助项目(2002HBL25)

摘　　要：目的观察苯那普利(ACEI)、缬沙坦(ARB)及两药联合应用对慢性肾小球疾病患者血清血管紧张素Ⅱ(AngⅡ)、转化生长因子-β1(TGF-β1)水平的影响。方法89例伴有蛋白尿的慢性肾小球疾病患者随机分为3组,苯那普利组(ACEI)、缬沙坦组(ARB)和联合组(苯那普利+缬沙坦),疗程8～12周。分别检测各组的AngⅡ、TGF-β1、肾功能、24h尿蛋白定量及血压。结果苯那普利组及联合治疗组血清AngⅡ水平均较治疗前显著降低(P<0.05),缬沙坦组血清AngⅡ水平较治疗前上升(P<0.05),各组血清TGF-β1水平均较治疗前下降,差异有统计学意义(P<0.05),其中治疗后各组间单因素方差分析表明,联合治疗组血清TGF-β1水平与单独用药组相比差异有统计学意义(P<0.05)。治疗后各组蛋白尿均降低(P<0.05),苯那普利组及缬沙坦组之间差异无统计学意义(P>0.05),联合治疗组降低蛋白尿疗效优于苯那普利组及缬沙坦组(P<0.05)。结论苯那普利和缬沙坦联合治疗慢性肾小球疾病,可下调AngⅡ、TGF-β1的表达,进一步降低蛋白尿。Objective To investigate the effect of angiotensin sestem blockers（ ACEI, ARB,or combination of them） on the levels of serum Ang Ⅱ、TGF - β1 in patients with chronic glomerular disease. Methods 89 cases of chronic glomerular disease were randomly divided into 3 groups. Group A ： benazepril alone （ 30 cases） ; Group B ： valsartan alone （ 30 cases） ; and Group C ： combination of benazepril and valsartan （ 29 cases）. The serum Ang Ⅱ、TGF - β1, renal function, quantity of 24 hour urinary protein, systolic pressure and diastolic pressure were measured before and after 8 - 12 weeks therapy. Results The level of serum Ang Ⅱ was effectively decreased in Group A and Group C （ P 〈 0.05 ）, in contrast to GroupC, the level of serum Ang Ⅱ was increased （P 〈 0.05）. Not only did combination of ACEI and ARB therapy reduce serum TGF - β1 more significantly than each of monotherapy did （ P 〈 0.05）. but also decreased proteinuria more effectively than that of benazepril alone or valsartan alone （ P 〈 0.05 ） Conclusion The combination of benazepril and valsartan may reduce the level of serum Ang Ⅱ、TGF - β1, and decrease urine protein excretion furthermore in patients with chronic glomerular disease

关 键 词：苯那普利 缬沙坦 联合用药 血管紧张素Ⅱ 转化生长因子Β1 

分 类 号：R692[医药卫生—泌尿科学]