氯沙坦联合前列地尔治疗高血压合并肾损害41例疗效观察  

Effect of Losartan Combined with Alprostadil on Treatment of Hypertension with Renal Injury

作　　者：陶琳 梁军 马玉燕[2] TAO Lin;LIANG Jun;MA Yu-yan(Pharmacy Dept.,the Maternal and Child Health Care of Laiwu City,Laiwu ,Shandong,271100)

机构地区：[1]山东省莱芜市妇幼保健院药剂科,山东莱芜271100 [2]山东省莱芜市人民医院万福园门诊,山东莱芜271100

出　　处：《医学临床研究》2018年第11期2113-2114,2117,共3页Journal of Clinical Research

摘　　要：【目的】探讨氣沙坦联合前列地尔治疗高血压合并肾损害患者的临床疗效。【方法】选择2015年3月至2017年3月收治的82例高血压合并肾损害[尿微量白蛋白和尿肌酐比值(UACR)>30mg/g]患者,根据随机数表法将其分为观察组和对照组,每组各41例。观察组联合使用氣沙坦和前列地尔,治疗时间为16周。检测两组患者治疗前、治疗后血压、肾功能、凝血功能相关临床指标。【结果】两组治疗后收缩压(SBP)、舒张压(DBP)、UACR、血清肌酐(SCr)、β2-微球蛋白(β2-MG)显著低于治疗前,肌酐清除率(Ccr)显著升高,观察组SBP、DBP、UACR、SCr显著低于对照组,观察组Ccr显著高于对照组,差异均具有统计学意义(P<0.05)。治疗后观察组纤维蛋白原(FIB)、D-D二聚体(D-D)水平均低于治疗前,且观察组FIB、D-D明显低于对照组,差异具有统计学意义(P<0.05);治疗前后两组凝血活酶时间(APTT)水平比较,差异无统计学意义(P〉0.05)。观察组1例恶心、1例头晕,发生率为4.87%(2/41),对照组1例呕吐、1例腹泻、1例心悸,发生率为7.32(3/41),差异无统计学意义(X2=0.213,P=0.644>0.05)。【结论】与单用氯沙坦相比,氯沙坦联合前列地尔治疗高血压合并肾损伤患者在有效降低患者的血压同时,可有效保护患者肾功能,且不良反应较少。[Objective]To investigate the effect of losartan combined with alprostadil on treatment of hyperten sion with renal injury.[Methods]From March 2015 to March 2017,82 patients with hypertension complicated with renal damage [urinary microalbumin and urinary creatinine ratio (UACR)>30mg/g]were divided into observation group and control group according to the random number method,41 cases in each group.The observa- tion group was treated with losartan and alprostadil for 16weeks.Blood pressure,renal function and coagulation function were measured before and after treatment.[Results]After treatment,the serum creatinine (Scr),β2-mi-croglobulin (β2-MG),SBP,diastolic blood pressure (DBP),UACR in both groups was significantly lower than those before treatment,and the creatinine clearance rate (Ccr)was significantly increased.SBP,DBP,UACR,Scr were lower than those of the control group,Ccr was significantly higher than that in control group (P<0.05),Af- ter treatment,the level of fibrinogen (FIB),D-D dimer (D-D)in the observation group was lower than that before treatment,and the FIB,D-D in the observation group was significantly lower than that in the control group (P<0.05).There was no significant difference in thromboplastin time (APTT)between the two groups before and after treatment (P>0.05).I case of nausea and 1 case of dizziness occurred in the observation group,the incidence rate was 4.87%(2/41).[Conclusion]Compared with Losartan alone,losartan combined with alprostadil can effectively protect renal function in patients with hypertension comolicated with renal injury.

关 键 词：高血压/药物疗法 肾疾病/药物疗法 抗高血压药/治疗应用 前列地尔/治疗应用 

分 类 号：R544.1[医药卫生—心血管疾病]