缬沙坦联合前列地尔治疗慢性肾小球肾炎的疗效及对肾功能、血流变学、t-PA和PAI-1的影响  

Curative effect of valsartan combined with alprostadil in treatment of chronic glomerulonephritis and influence on renal function,hemorrheology,t-PA and PAI-1

作　　者：王加平[1] 孟晓波[1] 李恒星[1] 梅燕[1] 

机构地区：[1]东海县人民医院检验科,江苏东海222300

出　　处：《海南医学》2017年第24期4036-4039,共4页Hainan Medical Journal

摘　　要：目的探究缬沙坦联合前列地尔治疗慢性肾小球肾炎(CGN)的临床疗效及对患者肾功能、血流变学指标、血清组织型纤溶酶原激活物(t-PA)、纤维蛋白溶解酶原激活物抑制剂-1(PAI-1)的影响。方法选取东海县人民医院2015年1月至2016年12月收治的80例CGN患者,并依据治疗方式的不同分为观察组(n=40)和对照组(n=40)。观察组采取缬沙坦联合前列地尔疗法,对照组仅给予缬沙坦治疗。两组均以4周为一个疗程,且连续治疗两个疗程。评价两组患者临床疗效,测定并比较两组患者治疗前后肾功能、血流变学及t-PA、PAI-1等水平。结果观察组患者的治疗总有效率为92.5%,明显高于对照组的75.0%,差异有统计学意义(P<0.05);治疗后,观察组患者的尿蛋白量(Upro)水平为(1.02±0.36)g/24 h,血肌酐(SCr)水平为(135.45±31.45)μmol/L,尿素氮(BUN)水平为(10.72±2.98)mmol/L,尿红细胞计数为(16.34±6.98)个/HP,对照组分别为(1.45±0.34)g/24 h、(168.76±29.46)μmol/L、(12.12±3.12)mmol/L、(26.92±9.59)个/HP,均较治疗前显著下降,且观察组显著低于对照组,差异均有统计学意义(P<0.05或P<0.01);治疗后,观察组患者的全血高切黏度为(3.23±1.27)mPa·s,全血低切黏度为(7.51±1.55)mPa·s,t-PA水平为(5.64±1.07)μmol/L,PAI-1水平为(27.65±4.60)μmol/L,对照组分别为(3.98±1.41)mPa·s、(8.47±1.62)mPa·s、(4.43±1.02)μmol/L、(38.74±5.06)μmol/L,两组均较治疗前显著下降,t-PA水平较治疗前显著升高,且组间比较差异均有统计学意义(P<0.05或P<0.01)。结论缬沙坦与前列地尔联用治疗CGN,可有效缓解患者肾功能状态,改善其血流速度,平衡机体血清t-PA和PAI-1水平,效果显著。Objective To explore the curative effect of valsartan combined with alprostadil in the treatment of chronic glomerulonephritis（CGN） and the influence on patients with renal function,hemorrheology,serum tissue plasminogen activator（t-PA）,plasminogen activator inhibitor-1（PAI-1）.Methods Eighty patients with CGN from January2015 to December 2016 in our hospital were divided into as observation group（n=40） and control group（n=40） in terms of different treatment methods.The observation group was treated with valsartan combined with alprostadil,and the control group with valsartan only.Each group was treated with two courses in succession,each of which was four weeks.The clinical efficacy was evaluated,and the renal function,hemorrheology,t-PA,PAI-1 were measured and compared between the two groups before and after treatment.Results The total effective rate of the observation group was 92.5%,significantly higher than that of the control group（75.0%）,P0.05.After treatment,the levels of urine protein（Upro）,serum creatinine（SCr）,blood urea nitrogen（BUN）,urine red blood cell count were（1.02±0.36） g/24 h,（135.45±31.45） μmol/L,（10.72±2.98） mmol/L,（135.45±31.45）/HP respectively in the observation group,which were significantly lower than the corresponding（1.45±0.34） g/24 h,（168.76±29.46） μmol/L,（12.12±3.12） mmol/L,（26.92±9.59）/HP respectively in the control group,and the levels of above in the two groups were all significantly lower than those before treatment（P0.05 or P0.01）.After treatment,the levels of the whole blood high shear viscosity,whole blood low shear viscosity,t-PA,PAI-1 were（3.23±1.27） m Pa· s,（7.51±1.55） μmol/L,（5.64±1.07） μmol/L,（27.65±4.60）μmol/L respectively in the observation group,which were significantly lower than the corresponding（3.98±1.41） m Pa·s,（8.47±1.62） μmol/L,（4.43±1.02） μmol/L,（38.74±5.06） μmol/L respectively in the control group,and the levels of above in the two gr

关 键 词：慢性肾小球肾炎 缬沙坦 前列地尔 肾功能 血清组织型纤溶酶原激活物 纤维蛋白溶解酶原激活物抑制剂-1 

分 类 号：R692.31[医药卫生—泌尿科学]