缬沙坦治疗高血压合并糖调节受损患者早期肾损害的短期临床疗效  

Clinical effect of short-term valsartan therapy on early renal damage in patients with essential hypertension and impaired glucose regulation

作　　者：张灵[1] 张春柳[1] 田国祥[1] 魏万林[1] 

机构地区：[1]北京军区总医院京西医院心内科,100144

出　　处：《中国心血管杂志》2013年第6期452-454,共3页Chinese Journal of Cardiovascular Medicine

摘　　要：目的探讨原发性高血压合并糖调节受损(IGR)患者早期肾损害的情况与缬沙坦的短期干预效果。方法顺序纳入275例高血压合并IGR的患者测定尿微量蛋白,对高血压合并IGR早期肾损害患者,使用缬沙坦80 mg/d治疗8周,治疗前后分别测定尿微量蛋白[尿白蛋白(Alb)、微量白蛋白尿排泄率(UAER)]。结果共筛查275例高血压合并IGR患者,有189例存在早期肾损害(68.73%),男女患病率分别为25.45%、43.27%,女性较男性高(χ2=9.573,P=0.00)。高血压合并IGR伴早期肾损害189例患者在缬沙坦治疗8周后收缩压、舒张压及脉压均有明显下降(均为P<0.05);虽然空腹血糖无明显变化,但可以显著降低餐后2 h血糖水平(P<0.01),微量白蛋白尿也显著降低。结论高血压合并IGR的患者存在早期肾损害者较多。缬沙坦在控制血压的同时,具有改善糖代谢异常,降低微量蛋白尿的作用。Objective To investigate the early renal damage condition and the effect of valsartan in patients with essential hypertension and impaired glucose regulation（IGR）.Methods A total of 275 cases of essential hypertension patients with IGR were studied.All the patients accepted valsartan 80 mg/d treatment for 8 weeks.Urinary albumin （Alb） and urinary albumin excretion rate （UAER） were measured and compared before and after the treatment.Results Of the 275 cases of hypertensive patients with IGR,189 cases （68.73%） have shown early renal impairment,and the male,female prevalence rate was 25.45% and 43.27%,respectively.The rate for female was higher than male patients and the difference was significant based on x2 test （x2 =9.573,P =0.00）.A total of 189 patients with essential hypertension and IGR in this study have significantly reduced systolic blood pressure,diastolic blood pressure and pulse pressure after 8 weeks of valsartan treatment （all P 〈 0.05）.Postprandial glucose level （P 〈 0.01） as well as micro albuminuria improved significantly after valsartan therapy.Conclusions Majority of patients with hypertension and IGR have early renal damage.Valsartan can decrease the blood pressure,reduce diabetes complications and improve impaired glucose regulation.

关 键 词：糖调节受损 高血压 早期肾损害 尿微量蛋白 缬沙坦 

分 类 号：R544.1[医药卫生—心血管疾病]